A 71-year-old man with hypertension, diabetes, and dyslipidaemia presents with a history of transient right-sided weakness and slurred speech. Carotid duplex ultrasound shows a heavily calcified, ulcerated plaque at the left internal carotid artery with marked luminal narrowing and post-stenotic colour-flow aliasing. Spectral Doppler interrogation reveals the measurement marked **C** in the diagram. Which of the following best describes the clinical significance of this finding?
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