title: "Isolated carotid bifurcation" and vertebral-carotid artery bypass for common carotid artery occlusion.
abstract: Symptomatic common carotid artery (CCA) occlusion is relatively rare, and requires an elaborate vascular reconstruction procedure with which many neurosurgeons are unfamiliar. We describe a case of CCA occlusion managed by vertebral artery (VA)-internal carotid artery (ICA) saphenous vein interposition graft. An 80-year-old man presented with deterioration of consciousness, transient aphasia, and severe right hemiparesis. Angiography revealed proximal occlusion of the left CCA with concomitant patent ICA. Cerebral blood flow measurement using iodine-123 N-isopropyl-p-iodoamphetamine and single photon emission computed tomography showed corresponding hemodynamic insufficiency of the left hemisphere. The patient underwent a novel revascularization procedure, in which the saphenous vein was used as an interposition graft between the V3 segment of the VA and the left proximal ICA. Postoperative course was uneventful, and patency of the bypass graft was confirmed. VA-ICA bypass with interposition graft is an alternative treatment option for symptomatic proximal CCA occlusion.
authors.affiliation: Department of Neurosurgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan. kazumata@med.hokkaido.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Kazumata
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Asaoka
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Taku
authors.initials: T
authors.lastname: Sugiyama
authors.forename: Sadahiro
authors.initials: S
authors.lastname: Kaneko
authors.forename: Kouji
authors.initials: K
authors.lastname: Itamoto
mesh_terms: D000369:Aged, 80 and over; D017536:Carotid Artery, Common; D016893:Carotid Stenosis / Q000601:surgery*; D002548:Cerebral Revascularization; D006801:Humans; D008297:Male; D012501:Saphenous Vein / Q000637:transplantation*