Ring-stripping retrograde common carotid endarterectomy: case report

Abstract

There is low mortality, and the procedure can be done through only one cervical incision. Tandem lesions of the carotid arteries can be treated together. It is suitable for long total occlusions of the common carotid, and long-term patency.

Two cases of symptomatic common carotid artery occlusion treated by carotid endarterectomy with L-shaped ministernotomy

“…[12] Klonaris et al summarized 146 patients who underwent surgical treatment for CCAO, with 114 cases (83.2%) undergoing bypass and 15 cases (10.9%) CEA. [14] ere have been some reports that CEA for the ICA or carotid bulb was combined with bypass for CCAO, [6,16] but only 19 cases of CEA performed alone for CCAO could be identified in a literature search, [2,4,12,13,15,17,18] and there was no report of CEA with partial sternotomy. e advantage of CEA for CCAO is that plaque can be removed and revascularization achieved at the same time.…”

Hybrid treatment of common carotid artery occlusion with ring-stripper endarterectomy plus stenting

“…Axial (aortocarotid bypass) or extra-anatomic procedures (subclavian-carotid bypass, carotid-carotid bypass, carotid-subclavian transposition) and variations in the performance of thromboendarterectomies are all possibilities. [8][9][10][11][12] Although extra-anatomic procedures have excellent patency (Ͼ90% at 5 years) and durability and avoid the morbidity of median sternotomy, they are usually performed in patients with significant cardiovascular comorbidi- ties who may be detrimentally affected because of the use of general anesthesia and the possible need of prosthetic devices and multiple incisions. 9,12 These procedures can be performed under regional anesthesia, but they require more dissection than standard carotid artery endarterectomy (CEA) and usually require longer or multiple incisions when bypass or transposition are combined with CEA.…”

“…[8][9][10][11][12] Although extra-anatomic procedures have excellent patency (Ͼ90% at 5 years) and durability and avoid the morbidity of median sternotomy, they are usually performed in patients with significant cardiovascular comorbidi- ties who may be detrimentally affected because of the use of general anesthesia and the possible need of prosthetic devices and multiple incisions. 9,12 These procedures can be performed under regional anesthesia, but they require more dissection than standard carotid artery endarterectomy (CEA) and usually require longer or multiple incisions when bypass or transposition are combined with CEA. Our patient had cardiac, pulmonary, and infectious comorbidities that mandated avoidance of general anesthesia and prosthetic material and thus prompted us to consider the performance of this uncommon reconstruction.…”

Stenting of the Stenotic Common Carotid Artery Ostium by the Buddy Wire Technique: A Case Report

“…[2][3][4][5][6][7][8][9][10][11][12] While reports restricting the target to the common carotid artery lesions are few, Linni et al 9) observed the absence of cranial nerve damage and lymphorrhea as advantages of endovascular treatment in a study restricted to 52 patients with common carotid artery lesions and recommended endovascular treatment as the first choice and other direct surgical procedures as useful alternatives. Van de Weijer et al 18) reported that lesion cross was impossible in 4 of the 144 patients who underwent endovascular treatment, particularly, in 2 of the 5 patients with occluded lesions.…”

“…To the present, various techniques including bypass, transposition, ring-stripping retrograde CEA, retrograde percutaneous transluminal angioplasty (PTA), CAS, and transfemoral PTA or CAS have been reported, but all these procedures are more complex than CEA or CAS for stenosis of the internal carotid artery origin. [2][3][4][5][6][7][8][9][10][11][12] In performing transfemoral CAS, securing of the stability of the guiding catheter poses a greater problem because of the more proximal location of the lesion, and various techniques for catheter stabilization have been developed. [10][11][12] We performed CAS with the buddy wire technique 13) and a distal filter protection device for a stenotic lesion at the origin of the common carotid artery and obtained a favorable outcome.…”