Amaurosis fugax: carotid endarterectomy without an angiogram.

The risks of carotid angiography--technical, allergic, cardiac, renal, or emotional--may be lessened or absented by the use of real-time B-mode ultrasound to evaluate carotid artery disease. A patient with amaurosis fugax, a positive fluorescein angiogram, ulceration on ultrasound, and an unremarkable computed tomography scan was operated on without angiography. The pathology was correct and the patient did well.