Surgical treatment of common carotid artery occlusion

Raymond S. Martin, William Edwards, Joseph L. Mulherin, William H. Edwards

    Research output: Contribution to journalArticle

    25 Citations (Scopus)

    Abstract

    Eight patients with common carotid artery (CCA) occlusion underwent bypass with saphenous vein to either the carotid bifurcation (five), the internal carotid artery (two), or the external carotid artery (one). Indications included ipsilateral transient ischemic attack (two), recent nondisabling hemispheric stroke (two), and transient nonhemispheric cerebral symptoms (two). Two asymptomatic patients with CCA occlusion and contralateral internal carotid stenosis underwent prophylactic revascularization prior to planned aortic surgery. There were no perioperative strokes, occlusions, or deaths. Late ipsilateral stroke occurred in two patients, and one patient had a single transient ischemic attack after 2 years. The four patients with preoperative transient cerebral ischemia experienced relief of their symptoms. Duplex ultrasound is an accurate screening modality for distal patency. Collateral filling of the internal or external carotid artery can usually be demonstrated after aortic arch or retrograde brachial contrast injection. End-to-end distal anastomosis after endarterectomy eliminates the original occlusive plaque as a potential source of emboli. The subclavian artery is preferred for inflow on the left. The CCA origin is easily accessible for inflow on the right. Bypass of the occluded CCA is safe and may be effective in relieving transient cerebral ischemic symptoms, although long-term ipsilateral neurologic sequelae may still occur.

    Original languageEnglish (US)
    Pages (from-to)302-306
    Number of pages5
    JournalThe American Journal of Surgery
    Volume165
    Issue number3
    DOIs
    StatePublished - Jan 1 1993

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    Common Carotid Artery
    Transient Ischemic Attack
    External Carotid Artery
    Stroke
    Internal Carotid Artery
    Therapeutics
    Endarterectomy
    Subclavian Artery
    Carotid Stenosis
    Saphenous Vein
    Embolism
    Thoracic Aorta
    Nervous System
    Arm
    Injections

    All Science Journal Classification (ASJC) codes

    • Surgery

    Cite this

    Martin, R. S., Edwards, W., Mulherin, J. L., & Edwards, W. H. (1993). Surgical treatment of common carotid artery occlusion. The American Journal of Surgery, 165(3), 302-306. https://doi.org/10.1016/S0002-9610(05)80830-X

    Surgical treatment of common carotid artery occlusion. / Martin, Raymond S.; Edwards, William; Mulherin, Joseph L.; Edwards, William H.

    In: The American Journal of Surgery, Vol. 165, No. 3, 01.01.1993, p. 302-306.

    Research output: Contribution to journalArticle

    Martin, RS, Edwards, W, Mulherin, JL & Edwards, WH 1993, 'Surgical treatment of common carotid artery occlusion', The American Journal of Surgery, vol. 165, no. 3, pp. 302-306. https://doi.org/10.1016/S0002-9610(05)80830-X
    Martin, Raymond S. ; Edwards, William ; Mulherin, Joseph L. ; Edwards, William H. / Surgical treatment of common carotid artery occlusion. In: The American Journal of Surgery. 1993 ; Vol. 165, No. 3. pp. 302-306.
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