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External carotid endarterectomy with patch angioplasty using internal jugular vein--two case reports
Insights
External carotid endarterectomy effectively treated internal carotid artery occlusion and external carotid artery stenosis, restoring cerebral blood flow and preventing symptoms. This surgical technique, including patch angioplasty and stump obliteration, is crucial for managing cerebral ischemia.
Area of Science:
- Vascular Surgery
- Cerebrovascular Disease
Background:
- Internal carotid artery occlusion and external carotid artery stenosis can lead to cerebral ischemia.
- Surgical intervention is necessary to restore blood flow and prevent neurological deficits.
Observation:
- Two male patients presented with occlusion of the right internal carotid artery and stenosis at the origin of the ipsilateral external carotid artery.
- Both patients experienced symptoms of cerebral ischemia.
Findings:
- External carotid endarterectomy with internal jugular vein patch angioplasty was performed in both cases.
- Special techniques, including Weck clip or suture plication, were used to obliterate the carotid artery stump.
- Post-surgery, cerebral blood flow increased, and patients remained asymptomatic.
Implications:
- External carotid endarterectomy is a viable treatment for specific carotid artery pathologies causing cerebral ischemia.
- Understanding the nuances of patch angioplasty and stump obliteration is vital for successful outcomes.
- This procedure can effectively restore cerebral perfusion and improve patient prognosis.
Abstract:
A 59-year-old male and a 74-year-old male presented with occlusion of the right internal carotid artery and stenosis at the origin of the ipsilateral external carotid artery manifesting as cerebral ischemia. External carotid endarterectomy with patch angioplasty using the internal jugular vein was performed. Special care was taken to obliterate the stump of the carotid artery using a Weck clip in one case and plication with non-absorbable sutures in the other. Cerebral blood flow in the affected hemisphere was increased after surgery and the patients remained asymptomatic. External carotid endarterectomy has several special aspects such as patch angioplasty and elimination of the stump which must be understood.