[Reconstructive vascular surgery in stenosis and kinking of the internal carotid artery]

Combination of stenosis and kinking of the internal carotid artery was revealed in 7.9% of 126 patients who underwent operation for stenosis of the bifurcation of the carotid artery. Among 9 patients with kinking of the internal carotid artery (ICA) 5 had a C-shaped kink, 2 - an S-shaped kink, and 2 patients looping of the artery. The combination led to a great measure to diminished volumetric cerebral blood flow (30-35 ml/min/g). The operations were performed under conduction anesthesia. Average time of ICA compression - 13 min. 26 sec. Retrograde pressure ranged from 42 to 88 mm Hg. In 2 cases the ICA was implanted into a new opening in the common carotid artery after eversion endarterectomy. The defect in the bifurcation was sutured. In 5 cases (4 with a C-shaped kink and 1 with an S-shaped kink) the artery was replanted into the former opening after eversion endarterectomy and resection of the kinked segment of the ICA. In 2 patients with looping of the artery the loop was resected with end to end anastomosis into the ICA and typical endarterectomy from the bifurcation of the carotid artery. There were no fatal outcomes. The results of operative treatment were good.