Absent right common carotid artery with stenting of symptomatic internal carotid artery stenosis
11
Citation
17
Reference
10
Related Paper
Citation Trend
Keywords:
Amaurosis fugax
External carotid artery
Carotid stenting
Common carotid artery occlusion is a relatively uncommon lesion (0.5-5% of patients with cerebral ischaemia). Cerebral revascularization is possible only in case of patent carotid bifurcation, three patients, all of them symptomatic (2 TIA's and 1 amaurosis fugax) with a complete common carotid artery occlusion have been treated with a subclavian-carotid artery by-pass (2 PTFE, 1 reversed saphenous vein). Among the patients one death occurred in the fourth postoperative day by bronchopneumonia, no stroke was detected, in the remaining two, the by-pass was patent one year and respectively three years post-operatively. In case of common carotid artery occlusion, visualization of bifurcation is usually better obtained through a color-duplex than arteriography. Several operations have been proposed in these patients (retrograde thrombectomy, carotid to carotid by-pass, carotid-subclavian reimplantation), but subclavian to carotid by-pass is the most safe and common used procedure.
Amaurosis fugax
Stroke
External carotid artery
Cite
Citations (3)
Amaurosis fugax
External carotid artery
Endarterectomy
Carotid artery disease
Cite
Citations (11)
Symptomatic common carotid artery (CCA) occlusion is an uncommon occurrence that may require surgical intervention. We aim to describe a case of CCA occlusion that presented with the unusual symptom of recurrent syncope. A 69-year-old lady presented with a history of recurrent syncopal episodes and amaurosis fugax associated with left leg weakness. She was found to have a right CCA occlusion on duplex ultrasound and angiography. She underwent a right common carotid endarterectomy and intraoperative findings revealed a heavily calcified plaque in the CCA just proximal to the bifurcation with organised thrombus filling the CCA proximally. CCA occlusion can rarely present with recurrent syncopal episodes. Surgery may be curative.
Amaurosis fugax
Cite
Citations (6)
Background:The external carotid artery (ECA) and its branches serve as the major vascular
channels of the head and neck region. The present study was conducted to assess anatomical
variations in the branches of external carotid artery.
Materials & Methods: 60 neck-halves of embalmed cadavers were taken and variation in
ECA was determined.
Results: Average length of the external carotid artery from its origin by bifurcation of the
common carotid artery to itstermination is 8.2 cm on the right side and 8.0 cm on the left
side.Common variation was thyrolingual trunk in 6, direct origin of STA from CCA in 10,
linguofacial trunk in 25, occipito-auricular trunk in 4, thyrolinguofacial trunk in 5, accessory
branches of ECA in 3, SLA direct branch of ECA in 2, terminal trifurcation of ECA in 4 and
sternocleidomastoid branch from CCA in 1 cadaver. The difference was significant (P< 0.05).
Conclusion: External carotid artery shows variations in its branching. A thorough knowledge
is must to avoid intra-operative secondary haemorrhage and post-operative complications.
External carotid artery
Cite
Citations (0)
• Three patients with proved internal carotid artery occlusion and diseased external carotid artery or common carotid artery had amaurosis fugax. Evidence for retinal embolization through external carotid collaterals is retinal emboli and infarction after carotid artery manipulation, amaurosis during external carotid angiography, and relief of amaurosis by endarterectomy of this vessel. The abundance of external carotid collaterals, their size, and natural incidence are discussed. Reports clinically support embolization to the central retinal artery and ophthalmic artery through these collaterals.
Amaurosis fugax
Carotid artery disease
Cite
Citations (60)
External carotid revascularization has been advocated to correct stenoses and obliterate sources of emboli in symptomatic patients with internal carotid artery (ICA) occlusion. Of more than 450 patients undergoing carotid surgery in an 8-year period, eight patients with amaurosis fugax, hemispheric transient ischemic attacks (TIAs), or global symptoms of cerebral ischemia in the presence of ICA occlusion underwent external carotid artery (ECA) reconstruction. There were five external carotid endarterectomies and three bypasses to the ECA, one from the common carotid artery and two from the subclavian artery. There were no operative deaths, but one minor ipsilateral stroke occurred after subclavian-ECA bypass. There was complete resolution of symptoms in all the other patients. Follow-up ranged from 4 months to 10 years (mean 3.4 years). It is concluded that ECA revascularization may be the best treatment option for relieving or improving late neurologic symptoms secondary to cerebral hypoperfusion and/or embolization through ECA collaterals in the presence of ICA occlusion and ECA stenosis.
Amaurosis fugax
External carotid artery
Stroke
Subclavian steal syndrome
Superficial temporal artery
Bypass surgery
Cite
Citations (2)
A pilot project studying the feasibility of external carotid-external carotid cross-over anastomosis for reconstruction of common carotid artery resection is reported. Common carotid artery resection in the treatment of head and neck malignancy may be necessary when carcinoma involves the common carotid or when the common carotid artery ruptures. Ligation of the common carotid is associated with high mortality rates and high rates of neurologic complications. The vasculature to the internal carotid can be maintained by anastomosing both external carotid arteries across the midline. The diseased common carotid can then be ligated below the bifurcation. The crossover anastomosis was performed successfully in six cadaveric dissections with unilateral neck dissection and laryngectomy. Mobilizing the facial artery in conjunction with the external carotid artery provides added length. A large vessel anastomosis across the midline was performed in six sheep. Technical errors in two sheep resulted in obstruction. The remaining four anastomoses remained patent. The external carotid-external carotid crossover anastomosis may have application in the management of squamous cell carcinoma involving the common carotid or in the treatment of carotid artery blowout. Further study is warranted.
External carotid artery
Cadaveric spasm
Neck dissection
Cite
Citations (3)
OBJECTIVE:To investigate the normal anatomic relations and histologic features of the cervical arteries and veins of goat, with the aim of providing a basis for resection and reconstruction of the common carotid artery.MATERIALS AND METHODS: Surgical dissection was performed on 15 healthy adult goats under general anaesthesia. The external diameters of the common carotid artery (CCA) and external jugular vein(EJV) were measured at their midpoints. 1 cm of the CCA and EJV was subject to light microscopic examination. Direct carotid angiography was performed on 2 selected goats to observe the course and branches of the carotid artery and normal blood flow mapping of the CCA was recorded using Laser Doppler Flowmeter. RESULTS:The average external diameter of the EJV was 5.4 mm for the left side and 5.3 mm for the right side. The average external diameter of the CCA was 3.8 mm for the left side and 3.6 mm for the right side. Histologic examinations found that the media of the carotid artery had 10-15 layers of smooth muscles. The EJV had valvulae, its wall was thin, only 1-2 layers of smooth muscle were contained in its medium. CONCLUSION:The CCA and EJV of the goat had a longer course in the neck, and a larger diameter (3-5 mm). Their histologic structures were similar to that of the human being, which makes it advantageous to be more often used as an animal model in experimental surgery.
External jugular vein
External carotid artery
Jugular vein
Digastric muscle
Cite
Citations (9)
Previous clinical trials have suggested that carotid-artery stenting with a device to capture and remove emboli ("embolic protection") is an effective alternative to carotid endarterectomy in patients at average or high risk for surgical complications.In this trial, we compared carotid-artery stenting with embolic protection and carotid endarterectomy in patients 79 years of age or younger who had severe carotid stenosis and were asymptomatic (i.e., had not had a stroke, transient ischemic attack, or amaurosis fugax in the 180 days before enrollment) and were not considered to be at high risk for surgical complications. The trial was designed to enroll 1658 patients but was halted early, after 1453 patients underwent randomization, because of slow enrollment. Patients were followed for up to 5 years. The primary composite end point of death, stroke, or myocardial infarction within 30 days after the procedure or ipsilateral stroke within 1 year was tested at a noninferiority margin of 3 percentage points.Stenting was noninferior to endarterectomy with regard to the primary composite end point (event rate, 3.8% and 3.4%, respectively; P=0.01 for noninferiority). The rate of stroke or death within 30 days was 2.9% in the stenting group and 1.7% in the endarterectomy group (P=0.33). From 30 days to 5 years after the procedure, the rate of freedom from ipsilateral stroke was 97.8% in the stenting group and 97.3% in the endarterectomy group (P=0.51), and the overall survival rates were 87.1% and 89.4%, respectively (P=0.21). The cumulative 5-year rate of stroke-free survival was 93.1% in the stenting group and 94.7% in the endarterectomy group (P=0.44).In this trial involving asymptomatic patients with severe carotid stenosis who were not at high risk for surgical complications, stenting was noninferior to endarterectomy with regard to the rate of the primary composite end point at 1 year. In analyses that included up to 5 years of follow-up, there were no significant differences between the study groups in the rates of non-procedure-related stroke, all stroke, and survival. (Funded by Abbott Vascular; ACT I ClinicalTrials.gov number, NCT00106938.).
Amaurosis fugax
Carotid stenting
Stroke
Endarterectomy
Clinical endpoint
Cite
Citations (540)
<i>Objectives:</i> To describe a new technique to repair injuries of the common carotid artery. <i>Clinical Presentation and Intervention:</i> A 30-year-old man sustained an iatrogenic injury to the left common carotid artery during surgical dissection of a left branchial cyst. The artery was repaired as follows: the left external carotid artery was ligated distally, its stump was longitudinally opened to create an arterial flap, which was then used to repair the defect in the common carotid artery. The patient remained free of any symptoms throughout 1 year of follow-up. <i>Conclusion:</i> Use of an external carotid flap provides an alternative method of repairing an injured carotid artery.
External carotid artery
Carotid Artery Dissection
Cite
Citations (0)