Transluminal angioplasty of the bilateral high internal carotid artery was successfully performed without complications. The effectiveness of the procedure was proven by amelioration of common carotid flow and improvements of clinical symptoms. The authors wish to draw attention to factors that must be considered in selecting patients who are likely to benefit from this procedure; on the basis of such a protocol; internal carotid angioplasty may become by method of choice in appropriate cases.