Problem: High-grade right internal carotid artery stenosis Postoperative Diagnosis: High-grade right internal carotid artery stenosis Procedures: Right carotid thromboendarterectomy and bovine patch angioplasty Indications: A 61-year-old woman with high-grade stenosis detected on duplex imaging. The technique, risks, and benefits of the procedure were discussed at length with the patient and the patient agreed to proceed.