Indirect Duplex Ultrasound Diagnosis of Innominate Artery Occlusive Disease

Herein, we present a case study of a patient with suspected transient ischemic attacks who was referred to the vascular laboratory for an assessment of the extracranial cerebrovascular arteries. Duplex ultrasound revealed momentary flow reversal in the right common carotid artery and internal carotid artery. Reverse flow in the right vertebral artery and a dampened Doppler waveform in the right subclavian artery were suggestive of a subclavian steal syndrome. These findings were consistent with innominate artery (IA) stenosis or occlusion. This case study is confirmatory evidence that indirect sonographic techniques can reliably identify IA occlusive disease.