Case 77: Ultrasound, Carotid 

Question Answered step-by-step Case 77: Ultrasound, Carotid LOCATION: Outpatient, Hospital PATIENT: Kerry Redder PHYSICIAN: Morton Monson, MD Clinical history is history of left CEA. Follow-up showed stenosis on right. Patient had previous study. Atherosclerotic plaque is identified on the right including hyperechoic and some hypoechoic plaque is seen. Atherosclerotic plaque is seen along the carotid bulb extending along the proximal internal carotid and proximal external carotid arteries. Peak systolic velocity right common carotid artery equals 74 cm/sec consistent with 50% to 75% stenosis. This is not significantly changed since previous value of 193 cm/sec. Peak systolic velocity right external carotid artery is somewhat elevated at 136 cm/sec. Previous value 89 cm/sec. IC/CC ratio 2.5 Right vertebral artery appears antegrade in flow. Vessels on the left are noted to be somewhat tortuous. Obvious plaque is not identified on the left. Peak systolic velocity left common carotid artery equals 93 cm/sec, and left internal carotid artery equals 85 cm/sec. Peak systolic velocity left external carotid artery 101 cm/sec, and IC/CC ratio on the left 0.91. Left vertebral artery appears antegrade inflow. IMPRESSION 1. Findings consistent with 50% to 75% stenosis right internal carotid artery. This has not significantly changed from prior study. 2. Somewhat elevated right external carotid artery is now seen with a peak systolic velocity of 136 cm/sec, suggesting some narrowing/stenosis there now. 3. Atherosclerotic plaque identified on the right as discussed above. 4. Vessels are tortuous on the left. No evidence of hemodynamically significant stenosis on the left. No obvious plaque identified. CPT Code(s):____________________________________________________________________________________ ICD-10-CM Code(s):______________________________________________________________________________ ICD-9-CM Code(s):_______________________________________________________________________________ Abstracting Questions 1. According to the report, what was the percentage of stenosis of the right internal carotid artery?________ to _______ 2. Point 4 under the Impression section of the report indicated ” Vessels are tortuous on the left. ” What is the definition of the term tortuous? _____________________________________________________________________________ Health Science Science Nursing MOA 115 Share QuestionEmailCopy link Comments (0)