Surgical Revascularization of Symptomatic Kinking of the Internal Carotid Artery

Vasc Endovascular Surg. 2016 Oct;50(7):470-474. doi: 10.1177/1538574416671246. Epub 2016 Sep 28.

Abstract

Objective: To evaluate the safety and outcomes of surgical revascularization for patients with symptomatic kinking of the internal carotid artery (ICA).

Methods: Twenty-five consecutive patients presented with symptomatic kinking of the ICA and a history of transient ischemic attack (TIA) or stroke were prospectively enrolled in this study. All patients were treated with ICA transection and end-to-side reimplantation at the level of the carotid bulb. Patients were followed up for a median of 32 months.

Results: There were no deaths or strokes within the 30 days of the treatment. No postprocedural thrombosis or narrowing of the ipsilateral ICA was observed. One (4%) patient had temporary recurrent nerve palsy, which was completely recovered at 4-week follow-up. One (4%) patient had a myocardial ischemic event. At the end of the 32-month follow-up, 1 (4%) patient developed ipsilateral minor stroke. No recurrent stenosis was detected by Doppler ultrasound.

Conclusion: Surgical treatment for isolated, symptomatic kinking of the ICA and a history of TIA or stroke is safe, and the outcomes are acceptable.

Keywords: internal carotid artery; kinking; revascularization; stroke; surgery.

MeSH terms

  • Adult
  • Aged
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / surgery*
  • Carotid Stenosis / complications
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / surgery*
  • Computed Tomography Angiography
  • Endarterectomy, Carotid
  • Female
  • Humans
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / etiology*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Prospective Studies
  • Replantation
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures / adverse effects
  • Vascular Surgical Procedures / methods*