Clinical Images: Candle-flame-like severe stenosis of the left common carotid artery.
Nasser Mahera, Kurtca Mirayb, Calderon Evelync
a. *Corresponding author: Nasser Maher, Maher M. Nasser, M.D., F.A.C.C., F.S.C.A.I. Clinical Professor, Baylor College of Medicine, Consultant Cardiologist, Baylor St. Luke’s Medical Center, CHI Health System, Texas Heart Institute, HCA Healthcare, and Houston Methodist Hospital. 1213 Hermann Drive, Ste 340, Houston, TX 77004, Office #: 713-796-1115, Office fax: 713-796-2066. Email: mmnmd.1970@gmail.com. ORCID iD: https://orcid.org/0000-0003-2619-2322
b. Dokuz Eylul University, Faculty of Medicine, Dokuz Eylül Ünv. Hst., İnciraltı, 35330 Balçova/İzmir, 35210, TR. Email: mkurtca.96 @gmail.com. ORCID iD: https://orcid.org/0000-0002-9342-8211
c. University of Guayaquil, Faculty of Medicine, Av. Delta y Av. Kennedy. Guayaquil, Guayas, 090112, EC. Email:ejcalderonm@gmail.com. https://orcid.org/0000-0003-0657-6978
An 87-year-old male retired lawyer who came to our outpatient clinic and reported expressive aphasia, weakness in the right upper extremity, and inability to write as normal. Symptoms were highly suggestive of TIAs. On physical examination, he had a loud left carotid bruit. Carotid Doppler suggested a high-grade lesion of left common Carotid Artery. Carotid angiogram showed a severe candle-flame-like narrowing in the left common carotid artery that extended to the bulb area with post stenotic dilatation (Figure 1). The patient underwent successful left carotid endarterectomy with no complications and no recurrence of TIAs symptoms on further follow-up.
TIAs are short events of neurologic function alteration caused by a regional reduction in blood flow to the brain without permanent sequels. [1,2] Strokes can cause long-term disability and death. Death rate increases with subsequent strokes, which often occur within one year of the first attack. TIAs and strokes can be caused by blockages and severe stenosis of carotid arteries. Carotid endarterectomy may reduce the possibility of repeated episodes of TIAs, as well as stroke and its complications, including death in patients with severe carotid occlusion. [3]
Keywords: Carotid stenosis, TIA, Stroke.