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Updated: Oct 22, 2025
Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
Surgery for near occlusion of the internal carotid arteries. A single center experience
Giulia Pinuccia Pisani1, Francesca Calabretto2, Gaia Maccario2
1University of Pavia School of Medicine, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Pavia, Italy; University of Pavia School of Medicine, Unit of Cardiac Surgery, Intrathoracic Transplantation and Pulmonary Hypertension, Pavia, Italy.
Abstract:
Several experiences have shown the benefits of carotid endarterectomy (CEA) to treat symptomatic acute occlusion of common and internal carotid arteries. Instead, surgery for carotid near occlusion remains controversial. We report successful surgical treatment in three patients with near occluded carotid artery. Doppler ultrasound scan was performed and showed common or internal carotid artery (ICA) near occlusion with controlateral carotid stenosis <50% (NASCET) with distal recanalization supported by collateral arteries of the external carotid artery (ECA) documented by preoperative CT-scan or selected angiography. Cases were treated by CEA of bifurcation and common-internal carotid bypass, using a PTFE graft or with longitudinal CEA and direct reconstruction. Perioperative and three months follow-up were free from new neurological events. In conclusion surgery for carotid near occlusion can be safely and successfully performed in selected cases with distal recanalization.
