Kirk et al.
I agree the plaque is almost always in the first several cms of the bifurcation. The normal measurements are taken from there. Did someone measure normal velocities more dismally in the bulb. AMK issue was someone have a DICA velocity of over 125 cm/s and the reader wished to call it stenosed. The technologist rightly pointed out there was no stenosis and no plaque there. The reader said “why not read elevated velocity in the DICA, maybe its hard to see plaque and the high velocity indicates a stenosis.”  

I agree your references did discuss measuring the velocity in stenosis and they show the PICA is where the stenosis is. The Blackshear article does mention a normal range for the PICA. Do you know if someone measured the  MICA and DICA in normals and their ranges?

With gratitude,
Larry

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