Ring-stripping retrograde common carotid endarterectomy: case report.
BACKGROUND
Total occlusion of the common carotid is rare and the indications and techniques for surgical treatment are still a matter of controversy.


OBJECTIVE
To demonstrate the feasibility of retrograde common carotid endarterectomy.


METHODS
Retrospective case report study.


METHODS
Tertiary care private hospital.


METHODS
Three patients underwent ring-stripping retrograde common carotid endarterectomy. Their ages were 81, 68 and 65 years. All were hypertensive with generalized atherosclerosis, two had diabetes mellitus, and one had undergone coronary artery bypass some years earlier and had non-dialytic chronic renal insufficiency. Symptoms of brain ischemia were present in two patients. All patients had total occlusion of the common carotid, extending from the origin to the bifurcation and localized in the right common carotid in two cases. In two cases the internal carotid artery was also occluded.


METHODS
Postoperative early mortality and stroke rate, and the medium and long-term endarterectomy patency.


RESULTS
There were no deaths. One patient had a transient ischemic attack. All endarterectomies were patent after eight months, four years and seven years of follow-up.


CONCLUSIONS
There is low mortality, and the procedure can be done through only one cervical incision. Tandem lesions of the carotid arteries can be treated together. It is suitable for long total occlusions of the common carotid, and long-term patency.
Aguiar
Eduardo Toledo de
ET
Departamento de Cirurgia, Faculdade de Medicina, Universidade de São Paulo, Brazil. etaguiar@usp.br
Lederman
Alex
A
Matsunaga
Patrícia
P
D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000601:surgery*; D017536:Carotid Artery, Common / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome