External carotid endarterectomy with internal carotid artery transposition flap angioplasty for symptomatic internal carotid artery occlusion |
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| Affiliation: | 1. Meharry Medical College, Nashville, Tennessee, USA;2. Department of Orthopedic Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA;1. Department of Neurological Surgery, Mayo Clinic Florida, Jacksonville, Florida, USA;2. Department of Neurosurgery and Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA;3. Department of Neurosurgery, Mayo Clinic Health Systems, Eau Claire, Wisconsin, USA;1. School of Medicine, University of Caxias do Sul, Caxias do Sul, Brazil;2. School of Medicine, University of São Paulo, São Paulo, Brazil;3. Barrow Neurological Institute, Phoenix, Arizona, USA;1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;2. Department of Neurology, The Hugo W. Moser Research Institute at Kennedy Krieger Inc., Baltimore, Maryland, USA;3. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;1. Department of Neurobiology & Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA;2. Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA;3. Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA;4. Department of Pediatric Radiology, St. Christopher''s Hospital for Children, Philadelphia, Pennsylvania, USA |
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| Abstract: | The external carotid artery is an important collateral pathway for cerebral perfusion when the internal carotid artery is occluded. After internal carotid artery occlusion, there is a definite risk of ipsilateral neurological events. The authors retrospectively examined their experience with endarterectomy of the external carotid artery for symptomatic internal carotid artery occlusion. Results based on the authors' experience and on historical data show external carotid endarterectomy to be a safe procedure. Obliteration of the cul-de-sac appears to be a very important factor in the prevention of reocclusion or recurrence of symptoms after external carotid endarterectomy. Use of the internal carotid artery stump for patching of the endarterectomized external carotid artery is both safe and effective in treating symptomatic internal carotid artery occlusion. |
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