Department of Surgery, Lehigh Valley Hospital, Allentown, PA, USA.
Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Vascular. 2024 Aug;32(4):792-796. doi: 10.1177/17085381231164015. Epub 2023 Mar 14.
Ocular Ischemic Syndrome (OIS) is a rare, vision threatening condition associated with severe carotid artery disease. There are few cases of OIS reported in the literature.
We present the case of a 54-year-old male with history of multiple previous carotid interventions including a right carotid stent, who presented with right-sided OIS.
CTA and angiogram showed a severe calcific plaque causing restenosis of the right carotid stent, with a patent right internal carotid artery (ICA) in the very distal neck. The right common carotid artery (CCA) was patent but diseased with ulcerated plaque extending proximally to below the level of the clavicle. The left CCA was chronically occluded from its origin all the way to the bifurcation. Given our patient's surgical history, the imperative to revascularize the ipsilateral carotid, and a diffusely diseased ipsilateral CCA, he was successfully treated with an ipsilateral subclavian to internal carotid bypass.
There is paucity of data regarding the best approach for carotid revascularization in OIS. This case report discusses our unique perioperative decision making as well as relevant literature.
眼部缺血综合征（OIS）是一种罕见的、威胁视力的疾病，与严重的颈动脉疾病有关。文献中很少有 OIS 的病例报道。
我们报告了一例 54 岁男性的病例，该患者有多次颈动脉介入治疗史，包括右侧颈动脉支架置入术，他出现了右侧 OIS。
CTA 和血管造影显示严重的钙化斑块导致右侧颈动脉支架再狭窄，右侧颈内动脉（ICA）在非常远端的颈部通畅。右侧颈总动脉（CCA）通畅，但有病变，溃疡斑块向上延伸至锁骨下方。左侧 CCA 从起源处到分叉处都有慢性闭塞。鉴于患者的手术史、对同侧颈动脉再血管化的迫切需求以及同侧 CCA 弥漫性病变，我们成功地对其进行了同侧锁骨下动脉至颈内动脉旁路移植术。
关于 OIS 中颈动脉再血管化的最佳方法，数据很少。本病例报告讨论了我们独特的围手术期决策以及相关文献。
