Surgical Treatments in a Case with Multiple Extracranial Cerebral Vascular Occlusive Disease

Abstract

The surgical treatment and indication for multiple occlusive lesions at the extracranial cerebral arteries are controversial. We report on a surgically treated patient who had subclavian artery occlusion and carotid stenosis. He complained of dizziness with unconscious attack. Arterial blood pressure measured at the left arm showed evident low value in comparison to that at the right arm. Angiograms demonstrated the left subclavian arterial occlusion and the right cervical internal carotid arterial stenosis with ulceration. The two-stage operations were performed using an internal shunt system during the carotid arterial cross clamping. The first operation was right carotid endarterectomy and the second was left common carotid-subclavian bypass with Gore-tex vascular prosthesis. Postoperative angiograms demonstrated complete removal of the carotid lesion and patency of the bypass. The clinical course was excellent.