My humble opinion:
A hemodynamically significant stenosis (unless it's just a string sign) will
have an elevation of velocities and associated post-stenotic turbulence.  Is
that documented in the study?
Since the ECA only supplies the brain if it has been recruited as a
collateral pathway I would think that a prudent measure might  be to
evaluate periorbital flow (using evocative compressions of the facial artery
and its branches - resembles the Vulcan Mind Probe grip - do you remember
Spock did this to an entity and determined that it was in extreme pain? -
but I digress) and perhaps due a full TCD exam to evaluate intracranial


On Mon, Jan 26, 2009 at 1:48 PM, Barb Lemon <[log in to unmask]> wrote:

> Fellow Flownetters!
> Has anyone read anything describing TIA or CVA from a high grade ECA
> stenosis?  A physician has stated to me that you can get TIA's or CVA's from
> an ECA with  high grade stenosis.   ( Right ICA peak 116, Left ICA peak 76
> cm/sec)  Need some lit to support his claim.  I  wanted him to change his
> report  from claiming  "critical ECA stenosis,  "  because most PCP's would
> send that patient to a vascular surgeon based on that report.  Thanks in
> advance for your help! Barb
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Steve Knight BSc RVT RDCS
Specialists In Ultrasound, Inc.

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