Abstract
A 47-year-old patient had lesser development of her left limbs and face, smaller left vascular structures, and severe occlusive disease of the left internal carotid, left subclavian, left vertebral and left iliac arteries. In 12 examples of occlusion of a carotid artery, 10/11 with unequal vascular luminal size had the occlusion on the smaller side. Of 20 patients with severe asymmetrical carotid stenosis, 13/17 with unequal size had more stenosis on the smaller side. These preliminary observations suggest that a small vessel may be more likely to occlude than its larger counterpart.

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