Carotid dissection is not typically a diagnosis made on ultrasound in an asymptomatic individual. Several factors made this case unique in the literature, including the fact that the dissection was in the distal common carotid artery rather than internal carotid, which allowed the injury to be directly visible by ultrasound. Rather than presenting with acute transient ischemic attack or stroke, headache, or cranial nerve palsy, this patient was referred for an asymptomatic bruit several months after the trauma, which presumably caused the dissection. The lesion identified by ultrasound was unusual, with a high-grade stenosis created by a mobile flap in the artery.

Sometimes a routine surveillance graft scan discloses something not so routine: in this case, giant pseudoaneurysms in the midsection of a lower-extremity bypass graft. This case report details a complication of cryopreserved vein grafts, underscoring the importance of routine surveillance imaging. It also illustrates adverse patient consequences that occur from a misdiagnosis with ultrasonography and demonstrates the critical role of the vascular sonographer in an integrated patient care team.