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2007 | 2 | 3 | 335-340

Article title

Threatening of cerebrovascular insufficiency within surgery of carotid artery restenosis


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Surgical intervention for extracranial carotid artery stenosis remains a major potential therapeutic modality for the prevention of stroke. Nevertheless, every kind of surgical technique for carotid entarterectomy (CEA) has its specific complications, compromising the final surgical result. The authors report about a 70-year old man, suffering from recurrent transient ischemic attacks by suspected internal carotid artery (ICA) re-stenosis, 11 and 13 years after CEA with patch angioplasty. In relation to neurological symptomatic and angiographic appearance of ICA re-stenosis an open surgery of the left ICA was preferred. Intraoperatively the old patch material was such vulnerable that it was not possible to maintain the continuity of ECA and ICA or CCA and ICA. Consequently reconstruction and replacement of ICA and ECA with 6 mm Gore-Tex grafts was performed. Follow-up three years after surgery showed no symptoms of insufficient brain metabolism as well as a good flow within the grafts. Patch angioplasty by CEA seems to be favourable to reduce the risk of early ICA re-stenosis but for all that there are other accompanying problems, which can compromise utility of patch technique. For this the authors prefer a patient adapted surgical treatment, based not only on so far not significant data but moreover on personal experience.










Physical description


1 - 9 - 2007
1 - 9 - 2007


  • Department of Neurosurgery, University of Muenster, 48129, Muenster, Germany
  • Cardiovascular Surgery, University of Muenster, 48129, Muenster, Germany
  • Department of Neurosurgery, University of Muenster, 48129, Muenster, Germany
  • Department of Neurosurgery, University of Muenster, 48129, Muenster, Germany


  • [1] H.C. Veldenz, R. Kinser and G.N. Yates: “Carotid graft replacement:a durable option”, J. Vasc. Surg., Vol. 47, (2005), pp. 220–226. http://dx.doi.org/10.1016/j.jvs.2005.04.004[Crossref]
  • [2] A.F. AbuRahma: “Patch closure improves results with carotid endarterectomy”, Semin. Vasc. Surg., Vol. 17, (2004), pp. 243–252. http://dx.doi.org/10.1016/S0895-7967(04)00044-4[Crossref]
  • [3] S. Raptis and S.R. Baker: “Infected false aneurysms of the carotid arteries after carotid endarterectomy”, Eur. J. Vasc. Endovasc. Surg., Vol. 11,(1996), pp. 148–152. http://dx.doi.org/10.1016/S1078-5884(96)80043-8[Crossref]
  • [4] C.L. Branch Jr. and C.H. Davis Jr.: “False aneurysm complicating carotid endarterectomy”, Neurosurgery, Vol. 19, (1986), pp. 421–425. http://dx.doi.org/10.1097/00006123-198609000-00015[Crossref]
  • [5] S. Palkovic, B. Fischer and H. Wassmann: “How useful is patch angioplasty in carotid endarterectomy”, Vascular, Vol. 12, (2004), p. 206. [PubMed]
  • [6] M.A. Mansour, S.S. Kang, W.H. Baker, W.C. Watson, F.N. Littooy, N. Labropoulos, N.P. Greisler: “Carotid endarterectomy for recurrent stenosis”, J. Vasc. Surg., Vol. 25, (1997), pp. 877–883. http://dx.doi.org/10.1016/S0741-5214(97)70217-9[Crossref]
  • [7] R. Herzig, P. Hlustik, K. Urbanek, M. Vaverka, S. Burval, J. Machac, I. Vlachova, B. Krupla, A. Bartkova, D. Sanak, J. Mares and P. Knovsky: “Can we identify patients with carotid occlusion who would benefit from EC/IC bypass? Review”, Biomed. Papers, Vol. 148, (2004), pp. 119–122.
  • [8] North American Symptomatic Carotid Endarterectomy Trial Collaborators: “Beneficial effect of carotid endarterectomy in symptomatic patients with highgrade carotid stenosis”, N. Eng. J. Med., Vol. 325, (1991), pp. 445–453. http://dx.doi.org/10.1056/NEJM199108153250701[Crossref]
  • [9] European Carotid Surgery Trialists’ Collaboration Group: “Randomised trial of endarterectomy for recently carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST)”, Lancet Vol. 351, (2001), pp. 1379–1387.
  • [10] H.H. Eastcott, G.W. Pickering and C.G. Rob: “Reconstruction of internal carotid artery in a patient with intermittend attacks of hemiplegia”, Lancet Vol. 267, (1954), pp. 994–996. http://dx.doi.org/10.1016/S0140-6736(54)90544-9[Crossref]
  • [11] S. Nene and W. Moore: “The role of patch angioplasty in prevention of early recurrent carotid stenosis”, Ann. Vasc. Surg., Vol. 13, (1999), pp. 169–173. http://dx.doi.org/10.1007/s100169900236[Crossref]
  • [12] R. Bond, K. Rerkasem, A.F. AbuRahma, A.R. Naylor and P.M. Rothwell: “Patch angioplasty versus primary closure for carotid endarterectomy”, Cochrane Database Syst. Rev., Vol. 2, (2004), CD000160. [WoS]
  • [13] B.A. Verhoeven, G. Pasterkamp, J.P. de Vries, R.G. Ackerstaff, D. de Kleijn, B.C. Eikelboom, F.L. Moll: “Closure of the arteriotomy after carotid endarterectomy: patch type is related to intraoperative microembili and restenosis rate”, J. Vasc. Surg., Vol. 42, (2005), pp. 1082–1088. http://dx.doi.org/10.1016/j.jvs.2005.08.011[Crossref]
  • [14] B.H. Borazjani, S.E. Wilson, R.M. Fujitani, I. Gordon, M. Mueller and R.A. Williams: “Postoperative complications of carotid patching: pseudoaneurysm and infection”, Ann. Vasc. Surg., Vol. 17, (2003), pp. 156–161. http://dx.doi.org/10.1007/s10016-001-0400-5[Crossref]
  • [15] Y. Yamamoto, D.G. Piepgras, W.R. Marsh and F.B. Meyer: “Complications resulting from saphenous vein patch graft after carotid endarterectomy”, Neurosurgery, Vol. 39, (1996), pp. 670–675. http://dx.doi.org/10.1097/00006123-199610000-00003[Crossref]

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