Carotid Resection for the Elongated Internal Carotid Artery

Abstract

Thirty-four patients underwent resection of the internal carotid artery (ICA) because of symptomatic elongation; 61.8% had suffered a stroke and 38.2% transient ischemic attacks (TIA). There were no asymptomatic patients; 35.3% were operated on for stenotic plaques without manifest elongation in preopera tive angiography but developed ICA kinking after endarterectomy. There was no mortality and no permanent neurologic deficit during the perioperative per iod. Within a follow-up interval with a mean of seventeen months there was 1 ipsihemispherical stroke (2.9%); in another asymptomatic patient duplex sono graphy revealed low-grade carotid stenosis. Thus 92% of the 35 patients who were followed up showed normal neurologic and sonographic findings during follow-up. The authors concluded that their technique of ICA resection, especially the use of an intraluminal shunt, is a safe method yielding satisfactory long-term results. Attention should be paid to the possibility of ICA kinking following local endarterectomy.