RT Journal A1 Bush RL, Bianco CC T1 IMage of the month—quiz case JF Archives of Surgery JO Archives of Surgery YR 2003 FD January 1 VO 138 IS 1 SP 109 OP 109 DO 10.1001/archsurg.138.1.109 UL http://dx.doi.org/10.1001/archsurg.138.1.109 AB A HEALTHY 72-YEAR-OLD woman was referred to a vascular surgeon after a carotid duplex scan demonstrated elevated velocities in her left internal carotid artery, consistent with an 80% to 99% stenosis. Questioning revealed an absence of symptoms such as extremity numbness or tingling, dysarthria, or amaurosis fugax. She was nonhypertensive and had never used tobacco products. Furthermore, her lipid and serum creatinine levels were within normal range, and there was no family history of atherosclerotic disease. The primary care physician gave her a regimen of one aspirin per day.