Symptomatic internal carotid thrombosis after carotid endarterectomy

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Presentation transcript:

Symptomatic internal carotid thrombosis after carotid endarterectomy Thomas A. Painter, M.D., Norman R. Hertzer, M.D., Patrick J. O'Hara, M.D., Leonard P. Krajewski, M.D., Edwin G. Beven, M.D. Journal of Vascular Surgery Volume 5, Issue 3, Pages 445-451 (March 1987) DOI: 10.1016/0741-5214(87)90053-X Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 A, Preoperative angiogram shows high-grade ostial stenosis (arrow) associated with cervical kink of the right internal carotid artery. B, Postoperative intravenous digital subtraction angiogram documents occlusion of entire right carotid system. C, Computed tomogram reveals right frontoparietal infarct (arrow) several days after urgent reoperation and incomplete neurologic recovery. D, Intravenous digital subtraction angiogram of the right carotid bifurcation 2 years later. (Table I, patient 5.) Journal of Vascular Surgery 1987 5, 445-451DOI: (10.1016/0741-5214(87)90053-X) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Technical features of urgent carotid reoperations. Gentle thrombectomy to restore prograde and retrograde flow (A). Immediate shunting for cerebral perfusion (B). Removal of adherent platelet thrombus or loose intima (note tacking sutures) (C). Vein patch angioplasty during arteriotomy closure (D). Journal of Vascular Surgery 1987 5, 445-451DOI: (10.1016/0741-5214(87)90053-X) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions