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[Progressive stroke in cases of common carotid occlusion--indication for revascularisation]

T Lesser1, S Venth, K Lesser

  • 1Gefässzentrum Gera, Klinik für Thorax- u. Gefässchirurgie, SRH Wald-Klinikum Gera gGmbH. thomas.lesser@wkg.srh.de

Zentralblatt Fur Chirurgie
|August 15, 2008
PubMed

Insights

Surgical revascularization for common carotid artery occlusion effectively treated progressive stroke symptoms. A novel aortic arch to internal carotid artery shunt restored cerebral perfusion, resolving neurological deficits.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Diagnostic Imaging

Background:

  • Progressive neurological symptoms in a 45-year-old man were investigated.
  • Standard diagnostic imaging revealed complex cerebrovascular pathology.

Observation:

  • Duplex sonography identified left common carotid artery occlusion with retrograde flow and pseudovenous flow in the internal carotid artery.
  • Transcranial duplex sonography demonstrated pseudovenous flow in the ipsilateral middle cerebral artery, indicating compromised intracranial collateral circulation.

Findings:

  • Operative revascularization using a primary shunt from the aortic arch to the internal carotid artery was performed.
  • Post-revascularization, perfusion of the left middle cerebral artery normalized, and neurological symptoms resolved.

Implications:

  • Revascularization for common carotid artery occlusion presenting with progressive stroke is a viable therapeutic option.
  • The described surgical technique and shunt placement ensure adequate cerebral perfusion in complex cases.

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