A technique for correction of carotid kinks and coils following endarterectomy
This study presents a technique to correct kinking or coiling of the internal carotid artery using patch angioplasty following endarterectomy, resection, and anastomoses of the vessel. Since 1984, 579 carotid endarterectomies have been performed with 19 patients (3.3%) having arteriosclerotic carotid bulb and internal carotid artery disease associated with a carotid kink or coil. These have been treated successfully using the technique of resection and patch angioplasty. The indications for surgery included seven patients with transient ischemic attacks (36.8%); seven patients who had suffered a cerebrovascular accident (36.8%); amaurosis fugax in two patients (10.5%); and one patient each with Hollenhorst plaque (5.3%), central retinal artery occlusion (5.3%), and an asymptomatic critical stenosis (5.3%). All patients had successful repair of the vessel using saphenous vein or Dacron patch angioplasty. There were no perioperative strokes or deaths. Follow-up ranged from four months to 58 months (mean 25 months). All vessels are patent with no evidence of stenosis. One patient had an ipsilateral cerebrovascular accident but had no evidence of recurrent carotid disease. Surgical correction of the carotid kink or coil can present a difficult surgical problem, and resection, fixation, or transposition can be complicated. The technique of endarterectomy, resection of the redundant vessel with anastomosis of the back wail, and patch angioplasty has been used effectively and safely in this series of patients.
Key wordsCarotid endarterectomy carotid kinks carotid coils extracranial atherosclerosis, See atherosclerosis atherosclerosis
Unable to display preview. Download preview PDF.
- 2.RISER MM, GERAUD J, DUCOUDRAY J, et al. Dolichointernal carotid with vertiginous syndrome.Rev Neurol 1951;85:10.Google Scholar
- 7.KRAYENBILL HAA, YASORGIL MC.Cerebral angiography. Philadelphia: J.P. Lippincott 1968, pp 24–27.Google Scholar
- 8.LIE TA.Congenital anomalies of the carotid arteries. Amsterdam: Excerpta Medica, 1968, pp 23–26.Google Scholar
- 15.SMITH BM, STANS VA, MAGGART MA. Operative management of the kinked carotid artery.Surg Gynecol Obstet 1986;162:69–72.Google Scholar