Carotid steal phenomenon occurs on which side?

• A. Left
• B. Bilateral
• C. Right
• D. Right Side

Answer: (D)

Carotid steal happens on the side where there is hemodynamically significant carotid disease. When one internal carotid artery is severely narrowed or occluded, the brain on that side relies on collateral pathways, usually from the external carotid system via the ophthalmic artery. This can cause the flow in the ipsilateral ophthalmic artery to become retrograde, effectively “stealing” blood toward the brain from the external carotid circulation. So the phenomenon is unilateral, aligned with the side of the stenosis or occlusion. If the stenosis is on the right, the steal is on the right; if it’s on the left, the steal is on the left.