ABSTRACT
These AP radiographs (A and B) of both a left (A) and right (B) CCA injection were taken at the same time sequence following injection. The stenotic and symptomatic lesion is on the right-hand side in this patient. It can be seen that the contralateral injection fills not only the left-sided middle cerebral artery but crosses over through the anterior circulation and fills a significant portion of the right middle cerebral artery. This would indicate that the nonoperative side is clearly dominant and suggests to me that the patient is at relatively low risk during carotid endarterectomy and most likely will not require shunting.
