We describe a strategy for carotid artery reconstruction using synthetic graft. Case 1 is 69 year-old man who presented with right hemiparesis. Angiography showed left carotid artery occlusion and right carotid artery stenosis. The subclavian-carotid artery bypass was performed using a knitted double-velour collagen-impregnated graft (Hemashield). Case 2 is 61 year-old woman who presented with a cervical fist-sized mass. The left common carotid artery were encased by thyroid cancer. Radical tumor resection and carotid artery reconstruction were performed using a ringed expanded polytetrafluoroethylene (ePTFE) vascular graft. Case 3 is 72 year-old man admitted to our clinic with complaint of hoarseness of three months' duration. Angiography demonstrated the encasement of the left carotid artery by a laryngeal tumor. Radical tumor resection and carotid artery reconstruction were performed using Hemashield. All reconstructed carotid arteries using synthetic graft have remained patent, and the postoperative course of all patients was good for a followed-up of 20 months (Case 1), 24 months (Case 2), and 10 months (Case 3). Synthetic graft can be performed satisfactorily in carotid arterial replacement with a medium caliber more than 6 mm in diameter.
