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 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.
Pintér
László
L
Department of Vascular Surgery and Endovascular Interventions, Augusta Hospital, Amalien Strasse 9, 40472 Düsseldorf, Germany. drpinter@t-online.de
Cagiannos
Catherine
C
Bakoyiannis
Chris N
CN
Kolvenbach
Ralf
R
D017130:Angioplasty / Q000295:instrumentation*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000295:instrumentation*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency