I wanted to share an interesting case.  A 69 yo man presented for a carotid
duplex.  On exam he was found to have a Rt CCA dissection with the flap
flapping in the common creating a jet and turbulence, and a Lt CCA low
velocity, low amplitude waveform which suggested a more proximal stenosis.
He came into the hospital the day prior with chest pain, bilat leg weakness
and HTN.  A cardiac cath was done on admittance to the hospital.  The
technologist called the referring doc to share her findings at 4P.  He was
concerned and consulted vascular service.  They did an angio and this patient
had a dissecting arch occurring and a string sign was noted on the left
proximal to the common.  He was wisked (is there an h in there?) off to
surgery and is doing fair.  Yes, once again the vascular technologist saved
his life.  Neat, huh?
Shelly Burns
Summa Health System
Akron, OH