title: [Proximal ligation of the parent artery for symptomatic tandem stenosis of the extradural internal carotid artery: a case report].
abstract: A 72-year-old man suffered blindness due to right central retinal artery occlusion. Cerebral angiography revealed tandem stenosis in the cervical, petrosal and cavernous portions of the right internal carotid artery (ICA). Blood flow from the vertebrobasilar artery via the right posterior communicating artery mainly perfused the right cerebral hemisphere. In addition, significant stenosis was observed in the left cervical carotid artery and the origin of the left vertebral artety. First, the patient underwent left carotid endarterectomy and vertebral artery to subclavian artery transposition. Two months later, ligation of the right ICA at its origin was performed. Postoperative course was uneventful and the patient has not experienced further ischemic events. We suggest that proximal ligation of the parent artery is a useful procedure for medically-refractory extradural ICA stenosis when surgical direct revascularization and percutaneous transluminal angioplasty cannot be performed.
authors: Department of Neurosurgery, Iwate Medical University, 19-1 Utimaru, Morioka 020-8505, Japan.
authors: Yasunori
authors: Y
authors: Suga
authors: Kuniaki
authors: K
authors: Ogasawara
authors: Hideo
authors: H
authors: Saito
authors: Masakazu
authors: M
authors: Kobayashi
authors: Takashi
authors: T
authors: Inoue
authors: Ryuji
authors: R
authors: Kondo
authors: Akira
authors: A
authors: Ogawa
mesh_terms: D000368:Aged; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D004388:Dura Mater / Q000098:blood supply*; D006801:Humans; D008026:Ligation / Q000379:methods*; D008297:Male; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*