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Surgical treatment of kinked internal carotid artery
Insights
Surgical correction of symptomatic kinking of the extracranial internal carotid artery (KICA) effectively treats cerebral ischemia. This procedure offers a low risk of complications, improving patient outcomes for this treatable condition.
Area of Science:
- Vascular Surgery
- Neurology
- Diagnostic Imaging
Background:
- Kinking of the extracranial internal carotid artery (KICA) is a significant, treatable cause of cerebral ischemia.
- The precise role of surgical correction for KICA remains under investigation.
Purpose of the Study:
- To evaluate the diagnosis and surgical treatment of symptomatic KICA.
- To assess the efficacy and safety of surgical correction for KICA.
Main Methods:
- Retrospective review of 21 patients undergoing surgery for symptomatic KICA between 1988-1994.
- Diagnosis utilized ultrasound, Doppler, CT, and angiography.
- Surgical techniques included kinking elimination, grafting, and correction of surrounding anatomical relationships.
Main Results:
- Seventeen of 21 patients experienced full recovery without neurological complications post-surgery.
- One patient died, one had a permanent neurological deficit, and two had transient ischemic attacks.
Conclusions:
- Anatomic reconstruction and elimination of kinked segments of the carotid artery can prevent cerebrovascular symptoms.
- Surgical correction of KICA is associated with low morbidity and mortality rates.
Background And Aims:
The aim of this study was to provide information on the diagnosis and treatment of kinking -- bends in the extracranial internal carotid artery (KICA), a rate but major and treatable cause of cerebral ischemia.
Project:
A retrospective review of the seven-year experience in Split Hospital. ESSENTIAL DATA: The role of the surgical correction of carotid artery kinking has not yet been precisely defined.
Materials And Methods:
Of the 86 carotid revascularization operations performed in 76 patients from 1988 to 1994, 21 (29%) patients underwent surgery owing to symptomatic kinking of the internal carotid artery. This group included 8 females and 13 males with a mean age of 57.3+/-5.5 years (range 44-70). Symptoms included cerebrovascular insults in 43%, hemispheric transient ischemic attacks in 33%, reversible ischemic neurological deficit in 24% of patients. The diagnosis was made using two-dimensional ultrasound scan and Doppler, computerised tomography and angiographic evaluation. Two methods were used: the elimination of kinking and graft of the internal artery onto the common carotid artery with excision of the kinked section of the artery and end-to-end anastomosis. Dense fibrous tissues around the kinked artery were removed and the artery was freed along its entire course. The anomalous relationship between the internal carotid artery, occipital artery and hypoglossal nerve was corrected.
Results:
After surgery seventeen patients fully recovered without neurological complications. One patient died, one patient suffered permanent neurological deficit, two suffered from transient ischemic attacks.
Conclusions:
Anatomic reconstruction together with the correction and elimination of the affected segments of the carotid artery may prevent progressive cerebrovascular symptoms and is associated with a low morbidity and mortality rate.