A case of internal carotid artery occlusion complicating embolization of the external carotid artery system

A case of visual disturbance by embolization through the external carotid artery (ECA) after internal carotid artery (ICA) occlusion is reported. A 65-year-old female presented left ICA occlusion 14 years ago. She was admitted with acute deterioration of left visual acuity. Ophthalmologically, the retinal central artery was occluded. Cerebral angiography disclosed an irregular wall at the left ICA stump and stenosis of the maxillary artery. Carotid endarterectomy of the common carotid artery, ECA and residual ICA was performed and atheromatous plaque with ulceration was removed. The postoperative course was uneventful. We discuss cases of ICA occlusion in relation to visual impairment.