Abstract
According to the literature data, the prevalence of restenosis after carotid endarterectomy ranges between 6 and 36%. The etiological factor is intimal hyperplasia for early period, whereas it is atherosclerosis for late period. A 67-year-old male patient admitted to our clinic with a history of headache and minor stroke. His medical history was significant for right carotid endarterectomy 8 years ago. Recent Doppler ultrasound and digital substraction angiography revealed 75% stenosis and kinking corresponding to the segment distal to the endarterectomy region. Surgical endarterectomy is the treatment of choice in critical carotid stenosis. Endovascular therapy is primarily considered for patients if there is restenosis after carotid endarterectomy. However, the treatment modality is controversial in cases with concomitant carotid stenosis and kinking of internal carotid artery. We present our surgical approach to a case with significant stenosis and kinking of internal carotid artery. We performed a 6-mm-PTFE graft interposition between common and internal carotid artery and resection of the kinking segment.
Highlights
Restenosis after carotid endarterectomy is reported to have rates of 6–36% in various studies from two to fifteen-month follow-up periods [1, 2]
Intimal hyperplasia is responsible in early period, while atherosclerosis is responsible in late period
Many factors play a role in the formation of atherosclerosis, but narrowing of the carotid artery due to kinking after endarterectomy is very rare in the literature
Summary
Restenosis after carotid endarterectomy is reported to have rates of 6–36% in various studies from two to fifteen-month follow-up periods [1, 2]. Many factors play a role in the formation of atherosclerosis, but narrowing of the carotid artery due to kinking after endarterectomy is very rare in the literature. For patients who develop restenosis after carotid endarterectomy, endovascular treatment is preferred, but patients who have restenosis with the presence of kinking in carotid artery are treated surgically. Eversion endarterectomy planned for the patient but severely ulcerated atherosclerotic plaque (invading the arterial wall) and very fragile arterial structure made us change our strategy peroperatively. Because of the length of the excised segment end-to-end anastomosis could not be performed. For this reason, synthetic graft (6 mm-ringed-polytetrafluoroethylene) interposition between the CCA (common carotid artery) and ICA (internal carotid artery) was performed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
