An Unusual Case: CCA Occlusion with Retrograde ICA Flow

Abstract

The detection of flow disturbances, occlusions, and stenosis of the extracranial carotid arteries with duplex imaging is painless and well tolerated by the majority of the population. A unique case presented to our Intersocietal Commission for the Accreditation of Vascular Laboratories-accredited vascular laboratory that demonstrated common carotid artery occlusion, antegrade external carotid artery flow with a rare finding of retrograde internal carotid artery flow. Using measures such as comparing the arterial flow to venous flow direction, the temporal tap maneuver, lowering pulse repetition frequency, and power Doppler, we were able to delineate this patient's unusual carotid hemodynamics.