Surgical Revascularization of Symptomatic Kinking of the Internal Carotid Artery.
OBJECTIVE
To evaluate the safety and outcomes of surgical revascularization for patients with symptomatic kinking of the internal carotid artery (ICA).


METHODS
Twenty-five consecutive patients presented with symptomatic kinking of the ICA and a history of transient ischemic attack (TIA) or stroke were prospectively enrolled in this study. All patients were treated with ICA transection and end-to-side reimplantation at the level of the carotid bulb. Patients were followed up for a median of 32 months.


RESULTS
There were no deaths or strokes within the 30 days of the treatment. No postprocedural thrombosis or narrowing of the ipsilateral ICA was observed. One (4%) patient had temporary recurrent nerve palsy, which was completely recovered at 4-week follow-up. One (4%) patient had a myocardial ischemic event. At the end of the 32-month follow-up, 1 (4%) patient developed ipsilateral minor stroke. No recurrent stenosis was detected by Doppler ultrasound.


CONCLUSIONS
Surgical treatment for isolated, symptomatic kinking of the ICA and a history of TIA or stroke is safe, and the outcomes are acceptable.
Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China Department of Neurosurgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, People's Republic of China.
Ji-Heng
JH
Hao
Department of Neurosurgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, People's Republic of China.
Li-Yong
LY
Zhang
Department of Neurosurgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, People's Republic of China.
Kai
K
Lin
Department of Neurosurgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, People's Republic of China.
Wei-Dong
WD
Liu
Department of Neurosurgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, People's Republic of China.
Shi-Gang
SG
Zhang
Department of Neurosurgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, People's Republic of China.
Ji-Yue
JY
Wang
Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China doctorligang@126.com.
Gang
G
Li
School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia lwang@csu.edu.au.
Le-Xin
LX
Wang
D000328:Adult; D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D000072226:Computed Tomography Angiography; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012092:Replantation; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*
internal carotid artery; kinking; revascularization; stroke; surgery