Thyrocervical trunk-external carotid artery bypass for positional cerebral ischemia due to common carotid artery occlusion. Technical note.
Medically refractory positional cerebral ischemia (PCI) and concomitant orthostatic hypotension associated with chronic common carotid artery (CCA) occlusion are rare. In this technical report, the authors describe an extracranial bypass in which the thyrocervical trunk was used as a donor vessel to treat three cases of CCA occlusion with PCI. Postoperatively, although orthostatic hypotension remained, ischemia-related symptoms resolved in all three patients and long-term graft patency was demonstrated. It is possible to treat cerebral ischemia due to CCA occlusion with extracranial bypass surgery. In these patients, the thyrocervical trunk proved to be a suitable donor vessel for the reconstitution of blood flow within the external carotid artery.
Melgar
Miguel A
MA
Department of Neurosurgery, Tulane University, New Orleans, Louisiana 70112-2699, USA. mmelgar@tulane.edu
Sahni
Deshdeepak
D
Weinand
Martin
M
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002545:Brain Ischemia / Q000209:etiology / Q000601:surgery*; D017536:Carotid Artery, Common / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery; D002548:Cerebral Revascularization / Q000379:methods*; D006801:Humans; D008297:Male; D009333:Neck / Q000098:blood supply* / Q000601:surgery*; D011187:Posture; D013961:Thyroid Gland / Q000098:blood supply* / Q000637:transplantation*