Ca-rotid endarteriectomy has proved to be the best medical care in pat
ients with symptomatic high-grade stenosis. This requires both accurat
e and reliable diagnostic tools for determining the degree of stenosis
. However, diagnostic criteria used in the relevant therapeutical stud
ies differ considerably. This may lead to crucial differences in the e
stimation of the findings in individual patients. We report a case whi
ch highlights such diagnostic problems, also in respect of the therape
utical options.