Common Carotid Artery Occlusion Treatment Case Reports
🩺 1. Endovascular Recanalization (Two-Case Series)
Jung‑Chi Hsu et al., 2020 (CVIR Endovascular) Two patients with symptomatic total CCAO were treated with:
- Percutaneous transluminal angioplasty
- Carotid stenting with distal protection
- Intravascular ultrasound (IVUS) guidance
Outcome: Technical success with symptom resolution and patent stents on follow-up.
🔧 2. Retrograde Ring-Stripper Endarterectomy
Qingjun Jiang et al., 2022 (Frontiers in Surgery) 67-year-old woman with limb-shaking TIA underwent:
- Retrograde ring-stripper endarterectomy for long-segment CCAO
Outcome: Restored cerebral perfusion and complete symptom resolution.
🔪 3. Carotid Endarterectomy with Partial Sternotomy
Surgical Neurology International Two cases of symptomatic CCAO treated with:
- Carotid endarterectomy (CEA)
- L-shaped partial sternotomy for proximal exposure
Outcome: Uncomplicated recovery with mRS ≤ 3 at discharge.
🔗 4. Hybrid Technique: Ring-Stripper CEA + Stenting
Journal of Vascular Surgery (2007–2008) Described hybrid approach combining:
- Ring-stripper-assisted CEA
- Carotid artery stenting
Outcome: Successful revascularization and improved flow in symptomatic CCAO.
🔄 5. Surgical Bypass (Axilloaxillary / Subclavian–ICA)
Multiple reports (ScienceDirect, ~2005) Bypass procedures performed:
- Axilloaxillary bypass for bilateral CCAO
- Subclavian–ICA bypass with saphenous vein grafts
Outcome: Durable graft patency and stroke prevention in mid-term follow-up.
📊 Summary Table
Approach | Case(s) | Outcome |
---|---|---|
Endovascular angioplasty + stenting | 2 cases | Symptom relief, stent patency |
Retrograde ring-stripper CEA | 1 case | Limb-shaking TIA resolved |
CEA + partial sternotomy | 2 cases | Safe access, good outcome |
Hybrid CEA + stenting | Multiple | Effective revascularization |
Subclavian or axilloaxillary bypass | ≥8 patients | Durable long-term patency |
🧠 Takeaway
- Endovascular therapy is feasible and minimally invasive for selected cases.
- Hybrid and surgical approaches remain essential for complex proximal occlusions.
- Individualized treatment depends on anatomy, symptoms, and collateral status.