ANOMALOUS BRANCH OF THE INTERNAL CAROTID-ARTERY MAINTAINS PATENCY DISTAL TO A COMPLETE OCCLUSION DIAGNOSED BY DUPLEX SCAN

A 67-year-old man had symptoms of peripheral vascular disease and was noted to have a carotid bruit. Duplex ultrasound examination of the ne ck demonstrated a short segmental occlusion of the proximal internal c arotid artery (ICA) with antegrade flow distal to the occlusion mainta ined by an anomalous branch of the ICA. Angiography confirmed the find ings and suggested that the branch was from the distribution of the oc cipital artery. The ICA findings were surgically proved, and endartere ctomy was successfully performed without complication. This case reinf orces the usefulness of duplex ultrasonography of the carotid arteries and is a rare situation in which a completely occluded ICA can be rep aired with a good clinical outcome.