Angiography in transient cerebral ischaemia using three views of the carotid bifurcation

A prospective study was made of 135 patients having cerebral angiography for suspected carotid atheroma. The aim was to assess the value of a technique in which selective injections were used to show the origins of the vessels from the aortic arch and three views were taken of each of the carotid bifurcations. Disease was frequently asymmetrical and was shown in only one of the three views of the carotid bifurcation in 44% of 181 patent atheromatous internal carotid arteries. Atheroma was seen on a single view significantly more often (p less than 0.01) than was complicated atheroma, indicating that the technique was showing more early lesions than would be seen with fewer views of the region. Disease was not shown significantly more often in any one particular view, so that all three are essential to examine the bifurcation completely.