[Surgical procedures on the external carotid artery]

Area of Science:

• Vascular Surgery
• Neurology
• Cerebrovascular Medicine

Background:

• Cerebral blood flow deterioration can cause significant neurological deficits.
• Internal carotid artery (ICA) occlusion is a common cause of impaired cerebral perfusion.
• External carotid artery (ECA) stenosis can exacerbate symptoms in patients with ICA occlusion.

Observation:

• A clinical series of five patients with symptomatic cerebral blood flow deterioration was studied.
• Patients presented with hemispheral symptoms or signs of diffuse cerebral hypoxia.
• Critical external carotid artery (ECA) stenosis was identified in conjunction with internal carotid artery (ICA) occlusion.

Findings:

• External carotid artery (ECA) reconstruction was performed using standard vascular surgical techniques with an intraluminal (i.l.) shunt.
• No early or late deaths occurred in the study group.
• One patient experienced a transient stroke post-operatively after contralateral carotid endarterectomy; however, all patients remained neurologically asymptomatic at a mean follow-up of 46 months.

Implications:

• External carotid artery (ECA) reconstruction is a safe and effective surgical option for managing critical cerebral perfusion impairment.
• This technique can be beneficial in selected cases of combined ICA occlusion and ECA stenosis.
• Further research may explore the long-term outcomes and broader applicability of ECA reconstruction in cerebrovascular disease.