Revascularization by Carotid Endarterectomy in the Case of Common Carotid Artery Occlusion

Abstract

  Common carotid artery occlusion with a patent ipsilateral internal carotid artery is a very rare condition, and revascularization is required in such cases.

  Here, we report the case of a 73-year-old man with diabetes mellitus in whom MR angiography and 3D-CT angiography showed that the left internal and external carotid arteries were patent but failed to visualize the left common carotid artery. Carotid ultrasonography demonstrated a very slow flow in the proximal portion of the left common carotid artery, rapid antegrade flow in the left internal carotid artery, and complete occlusion of the left common carotid artery near the bifurcation. Left carotid angiography showed the slow passage of the contrast material just proximal to the bifurcation of the left common carotid artery. Left vertebral angiography showed anastomosis between the muscle branches of the left vertebral artery and occipital artery. The left internal carotid artery was retrogradely visualized through the narrow space near the common carotid bifurcation. In this case, revascularization was performed using carotid endarterectomy without ischemic complications.

  Revascularization by carotid endarterectomy is possible even in cases of common carotid artery occlusion if the occluded portion is located near the bifurcation of the common carotid artery.