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Fig. 15B. —Superimposed cyclic flow perturbations in common carotid artery because of presence of intraaortic balloon pump. Doppler sonogram shows 36-year-old man with ischemic cardiomyopathy and intraaortic balloon pump. Less-organized wave pattern is seen in left common carotid artery of this patient. Presence of balloon pump complicates analysis of underlying carotid disease, and measurement of flow velocities may necessitate temporary deactivation of balloon pump.