Candle-Flame-Like Stenosis Carotid Lesion

An 87-year-old male retired lawyer who came to our outpatient clinic and reported expressive aphasia, weakness in the right upper extremity, and inability to write as normal. Symptoms were highly suggestive of TIAs. On physical examination, he had a loud left carotid bruit. Carotid Doppler suggested a high-grade lesion of left common Carotid Artery. Carotid angiogram showed a severe candle-flame-like narrowing in the left common carotid artery that extended to the bulb area with post stenotic dilatation (Panel A). The patient underwent successful left carotid endarterectomy with no complications and no recurrence of TIAs symptoms on further follow-up