A Case of Symptomatic Internal Carotid Artery Stenosis and Concomitant Ipsilateral Chronic Common Carotid Artery Occlusion Treated with Carotid Endarterectomy

Abstract

There is no consensus regarding the treatment of symptomatic common carotid artery occlusion (CCAO) or stenosis of common as well as internal carotid arteries (ICAs). We report a case of symptomatic left ICA stenosis and concomitant ipsilateral chronic CCAO treated with carotid endarterectomy (CEA). A 73-year-old man was admitted to our institution twice due to repeated infarctions. Repeated digital subtraction angiography demonstrated progressive stenosis of the left ICA origin and concomitant ipsilateral chronic CCAO. Single-photon emission computed tomography (SPECT) did not reveal any significant laterality. Therefore, rather than hemodynamic ischemia, atherothrombosis from the plaque at the ICA origin was presumed to cause repeated infarction. The patient underwent CEA limited to the ICA, considering the etiology of the infarction and surgical invasiveness. The postoperative course was uneventful. Ischemic attacks were not observed for 6 months postoperatively.