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Fig. 5B —57-year-old man with right-sided amaurosis fugax and innominate artery disease. Spectral waveforms from right internal carotid artery show abnormalities typical of innominate artery disease. Note sharp systolic spikes (arrowhead) and marked midsystolic deceleration (arrow) with flow to baseline or below during several cardiac cycles. ICA = internal carotid artery, PROX = proximal.