Introduction: Measurement of vessel stenosis using ultrasonography or magnetic resonance is still the principal method for determining the severity of carotid atherosclerosis and need for endarterectomy.
Case Outline: A 56-year-old male was admitted to the Cardiovascular Institute "Dedinje" due to a clinically asymptomatic restenosis of the operated left internal carotid artery (ICA). Angiography and magnetic resonance angiography (MRA) in previous hospitalization had revealed occluded right ICA. However, routine duplex ultrasonography revealed a high-grade restenosis (85%) of the left ICA and subocclusion of the right ICA by an ulcerated plaque (confirmed on repeated MRA).
Conclusion: Selective arteriography examination could misrepresent the degree of stenosis especially in patents with the ICA that seems to be occluded. MRA is considered the method of choice for identifying pseudo-occlusions of ICA.
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