Hybrid treatment of common carotid artery occlusion with ring-stripper endarterectomy plus stenting

Symptomatic occlusion of the common carotid artery with preserved circulation in the internal carotid artery is an uncommon occurrence. We describe a hybrid technique whereby a patient was treated with eversion carotid bifurcation endarterectomy, fluoroscopically guided retrograde ring-stripper comm...

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Bibliographic Details
Published in:Journal of vascular surgery 2007-07, Vol.46 (1), p.135-139
Main Authors: Pintér, László, MD, Cagiannos, Catherine, MD, Bakoyiannis, Chris N., MD, Kolvenbach, Ralf, MD, PhD
Format: Article
Language:English
Subjects:
Angioplasty - instrumentation
Biological and medical sciences
Carotid Artery, Common - diagnostic imaging
Carotid Artery, Common - physiopathology
Carotid Artery, Common - surgery
Carotid Artery, Internal - surgery
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - physiopathology
Carotid Stenosis - surgery
Endarterectomy, Carotid - instrumentation
Female
Humans
Imaging, Three-Dimensional
Medical sciences
Middle Aged
Neurology
Neurosurgery
Radiographic Image Interpretation, Computer-Assisted
Radiography, Interventional
Skull, brain, vascular surgery
Stents
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tomography, X-Ray Computed
Treatment Outcome
Vascular diseases and vascular malformations of the nervous system
Vascular Patency
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Description
Summary:Symptomatic occlusion of the common carotid artery with preserved circulation in the internal carotid artery is an uncommon occurrence. We describe a hybrid technique whereby a patient was treated with eversion carotid bifurcation endarterectomy, fluoroscopically guided retrograde ring-stripper common carotid endarterectomy, and stenting of residual stenosis in the disobliterated artery. Successful recanalization was achieved without adverse anatomic or neurologic sequelae. The patient remains asymptomatic with a radiographically patent reconstruction at 1 year. This combination of endovascular and open surgery enables the surgeon to address long occlusions of the common carotid arteries with control of the distal and proximal endarterectomy margins and obviates the need for general anesthesia or sternotomy.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2007.01.062