Bypass Surgery for Symptomatic Common Carotid Artery Occlusion with Arterial Grafts: A Report of Five Cases

Abstract

Anastomosis of the superficial temporal artery (STA) to the middle cerebral artery is useful for internal carotid occlusion cases. However, in the case of common carotid artery (CCA) occlusion, another bypass strategy should be sought because of insufficiency of STA blood flow. Various bypass strategies have been reported for common carotid artery occlusion, but no report describing a systematic surgical strategy has been published yet. We report five cases of symptomatic CCA occlusion treated with arterial grafts. In each case, the donor artery was determined according to the patency of the ipsilateral external carotid artery (ECA) and vertebral artery (VA). Consequently, all the cases were treated with vascular reconstruction successfully, and the symptoms disappeared postoperatively. Thus, categorization of CCA occlusion according to the patency of the ipsilateral ECA and VA could guide decision making regarding the appropriate bypass strategy systematically, even with approximately 20-cm arterial grafts.