41 Focal Plaque in Proximal Internal Carotid Artery—Left Carotid Exposure

A focal tight stenosis at the carotid bulb is shown. There is no extensive plaque either down the CCA or up the ICA, making this a relatively simple and straightforward exposure and plaque removal. However, the brown, discolored area of carotid plaque indicates the presence of intraplaque hemorrhage and an active plaque that no doubt was responsible for the patient’s symptoms. This is type of soft, friable plaque that is so often associated with intraplaque hemorrhage.