External carotid artery revascularization: indications, operative techniques and results

The external carotid artery (ECA) is an important collateral pathway in patients with ipsilateral internal carotid artery (ICA) occlusion and recurrent symptoms. An ipsilateral ECA revascularization can improve cerebral perfusion or eliminate an embolic source. In the past 11 years 11 patients underwent operation, 6 times for amaurosis fugax and 5 times for transient ischaemic attacks. Eight times ECA endarterectomy was performed for stenosis and/or ulceration. Eight times closure or separation of the ICA stump with thrombus was carried out. There were no perioperative neurological deficits or deaths, with the exception of 3 patients who already had a long-standing deficit due to the ICA occlusion. All patients were relieved of their ocular or hemispheric symptoms in a follow-up period of 8 years. Two late strokes occurred after 1 1/4 and 4 years. Ipsilateral ECA revascularization is an effective and safe operation and has good long-term results.