Countee R W, Vijayanathan T, Wu S Z
Neurosurgery. 1982 Oct;11(4):518-21.
Our experiences with a patient who developed recurrent hemispheric transient ischemic attacks 3 1/2 years after ipsilateral carotid endarterectomy are described. Although repeat arteriography demonstrated smooth and unobstructed common and internal carotid arteries and a normal intracranial circulation, there was complete occlusion of the external carotid artery at its origin, which appeared as a stump or diverticulum at the origin of the internal carotid artery. This stump was filled with atherothrombotic debris and served as a source of emboli to the adjacent and patent internal carotid artery. Excision of the stump effected complete relief of the recurrent ischemic symptoms. The pernicious potential of an external carotid obstruction when adjacent to a patent internal carotid artery should be recognized. To prevent this avoidable complication of carotid endarterectomy, we recommend that the origin of the external carotid artery be treated with the same standards of technical perfection as those customarily applied to the internal and common carotid arteries during this procedure.
本文描述了我们对一位患者的治疗经历，该患者在同侧颈动脉内膜切除术后3年半出现复发性半球短暂性脑缺血发作。尽管重复血管造影显示颈总动脉和颈内动脉通畅且无梗阻，颅内循环正常，但颈外动脉在其起始处完全闭塞，在颈内动脉起始处表现为残端或憩室。该残端充满动脉粥样硬化血栓碎片，是相邻通畅的颈内动脉栓子的来源。切除残端后，复发性缺血症状完全缓解。应认识到颈外动脉阻塞毗邻通畅的颈内动脉时的潜在危害。为防止这种颈动脉内膜切除术可避免的并发症，我们建议在该手术中，以通常应用于颈内动脉和颈总动脉的相同技术完美标准来处理颈外动脉的起始处。
