[HST]: TIA '00 ascribed to damage to left carotid from radiation for tongue  [SAS]: as above  Duplex Doppler carotid artery ultrasound:    Please also see report scanned into EMR.  RIGHT:  Flow velocities were obtained at the mid and distal common  carotid artery, external carotid, and proximal, mid and distal  internal carotid artery, are all in the normal range, consistent with  a 0-50 percent stenosis.  RIGHT ICA/CCA ratio: 0.9    LEFT: Flow velocities were obtained at the mid and distal common  carotid artery, external carotid, and proximal, mid and distal  internal carotid artery. Mid common carotid artery peak systolic flow velocity 167 cm/s  previously 81 cm/s which now corresponds to a 50 - 69 percent  stenosis. Distal common carotid artery peak systolic flow velocity 211 cm/s  previously 251 cm/s which now corresponds to a 50 - 69 percent  stenosis as before. External carotid artery peak systolic flow velocity 132 cm/s  previously 134 cm/s which now corresponds to a 50 - 69 percent  stenosis as before. A stent is present in the internal carotid artery. Proximal internal carotid artery peak systolic flow velocity 132 cm/s  previously 91 cm/s which now corresponds to a 0 - 50 percent stenosis. Mid internal carotid artery peak systolic flow velocity 95.5 cm/s  previously 66 cm/s which now corresponds to a 0 - 50 percent stenosis. Distal internal carotid artery 91.7 cm/s previously 58 cm/s which now  corresponds to a 0 - 50 percent stenosis. Soft plaque in the common carotid artery and bulb identified.   LEFT ICA/CCA ratio: 0.5   Bilateral vertebral arterial blood flow is antegrade.       IMPRESSION: No hemodynamically significant stenosis on the right.  On the left, there is 50-69% stenosis at the common carotid artery  and external carotid are as before; while the velocities involving  the internal carotid artery have increased since prior exam, there is  no hemodynamically significant stenosis involving the left internal  carotid.  ;   THE ULTRASOUND IMAGING SERVICES OF THIS FACILITY ARE ACCREDITED FOR  OB/GYN AND GENERAL  ULTRASOUND BY THE AMERICAN COLLEGE OF RADIOLOGY ______________________________________   Electronically signed by:AAAAA B CCCCCC, MD Date: 01/01/1901 Time:15:02