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Fig. 5A. —77-year-old woman with focal stenosis involving takeoff of great vessels as seen on contrast-enhanced MR angiography. Maximum-intensity-projection image from contrast-enhanced MR angiogram reveals tandem severe stenosis of left subclavian artery origin and farther distally at origin of left vertebral artery (arrows). Mild stenosis of origin of left common carotid artery is also seen. Note high-grade stenosis of left internal carotid artery at bifurcation and moderate stenosis involving right carotid bifurcation.