Related Experiment Video
Updated: Jun 23, 2026
Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
Endovascular revascularization of chronically occluded common carotid artery for symptomatic cerebral hypoperfusion
Soliman Oushy1, Nicholas Borg2, Sarosh Irfan Madhani3
1Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA.
Insights
Endovascular recanalization offers a viable treatment for symptomatic chronic carotid artery occlusion, reducing ischemic event risk. This case demonstrates a successful procedure using an intravascular guided re-entry catheter.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Cardiovascular Imaging
Background:
- Endovascular recanalization is a growing treatment for symptomatic chronic carotid artery occlusions.
- It can reduce ischemic event risk compared to medical management alone in select patients.
- However, the procedure presents technical challenges and risks.
Purpose of the Study:
- To demonstrate a case of successful endovascular recanalization and stenting.
- To illustrate the use of an intravascular guided re-entry catheter for chronic total occlusion.
- To highlight outcomes in a patient with recurrent transient ischemic attacks.
Main Methods:
- A 64-year-old woman with chronic total occlusion of the common carotid artery underwent endovascular recanalization and stenting.
- An intravascular guided re-entry catheter was utilized.
- Informed consent was obtained prior to the procedure.
Main Results:
- The endovascular recanalization and stenting of the chronically occluded left common carotid artery was technically successful.
- The patient experienced a postoperative neck hematoma that resolved.
- Neurological baseline was maintained, with no further symptoms at three-month follow-up.
Conclusions:
- Endovascular recanalization is a feasible option for carefully selected patients with symptomatic chronic carotid artery occlusion.
- Intravascular guided re-entry catheters can facilitate complex recanalization procedures.
- Successful revascularization can lead to symptom resolution and improved patient outcomes.
Abstract:
Endovascular recanalization is increasingly being utilized in symptomatic patients with chronically occluded carotid arteries.1 In carefully selected patients, endovascular recanalization has shown to lower the risk of ischemic events when compared to medical management alone.1 However, successful endovascular revascularization is technically challenging and not without risk.1, 2 In this video, we demonstrate a case of a 64-year-old woman who presented with recurrent transient ischemic attacks. On imaging she was found to have a chronic total occlusion of the common carotid artery from the arch. After obtaining informed consent, the patient underwent a successful endovascular recanalization and stenting of a chronically occluded left common carotid artery with aid from an intravascular guided re-entry catheter. Post operatively the patient developed a neck hematoma which improved and she returned to her neurological baseline. She reported no further symptoms on her three month follow up.
