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

• Published in: Journal of vascular surgery Vol. 46; no. 1; pp. 135 - 139
• Main Authors: Pintér, László, MD, Cagiannos, Catherine, MD, Bakoyiannis, Chris N., MD, Kolvenbach, Ralf, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.2007; Elsevier
• 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; Common carotid; Treatment; Ring; Surgery; Cardiovascular disease; Artery occlusion; Endarteriectomy
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2007.01.062

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.