Kotsis Thomas, Christoforou Panagitsa
Vascular Unit, 2nd Clinic of Surgery, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Vasc Specialist Int. 2020 Mar 31;36(1):38-44. doi: 10.5758/vsi.2020.36.1.38.
There is a lack of guidelines concerning common carotid artery (CCA) occlusive disease in the presence of a patent internal carotid artery (ICA). A novel surgical technique that disobliterates an occluded CCA was successfully performed in three cases. The detailed surgical steps are presented herein. After proximal division of the CCA behind the sternoclavicular junction, the occluded CCA was endarterectomized via antegrade ring stripping. After removal of the atheromatous core, the CCA was everted, and the wall remnants were cleaned under direct vision. Simultaneous eversion endarterectomy of the ICA was performed when necessary. After reversion of the CCA, it was transposed and anastomosed to the ipsilateral subclavian artery distal to the orifice of the vertebral artery. This novel technique can be used in selected cases by experienced surgeons.
目前缺乏关于存在通畅颈内动脉（ICA）时颈总动脉（CCA）闭塞性疾病的指南。一种使闭塞的CCA再通的新型手术技术在三例患者中成功实施。本文介绍详细的手术步骤。在锁骨胸锁关节后方近端切断CCA后，通过顺行环状剥离对闭塞的CCA进行内膜切除术。去除粥样硬化核心后，将CCA外翻，并在直视下清理血管壁残余物。必要时同时对ICA进行外翻内膜切除术。CCA复位后，将其移位并与椎动脉开口远端的同侧锁骨下动脉进行吻合。这种新技术可供经验丰富的外科医生在特定病例中使用。
