A 72-year-old woman with hypertension, hyperlipidemia, and prior coronary artery bypass grafting presents with a second episode of sudden monocular vision loss in the left eye over 8 minutes, described as a "window shade coming down" from superior to inferior visual field. Vision has fully recovered to 20/20 OU. Dilated funduscopy of the left eye reveals the structure marked **A** — attenuated retinal arterioles with segmental narrowing. Which of the following is the most likely etiology of her amaurosis fugax?
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