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Fig. 15A. —Superimposed cyclic flow perturbations in common carotid artery because of presence of intraaortic balloon pump. Doppler sonogram shows 55-year-old man with ischemic cardiomyopathy. Waveforms in right common carotid artery show second peak of forward flow (arrow) during systole corresponding to inflation of intraaortic balloon. At end of diastole, and immediately preceding next beat, there is transient reversal (arrowhead) that corresponds to deflation of balloon.