Angioplasty and Stenting of Totally Occluded Common Carotid Artery at the Chronic Stage -Case Report-

Endovascular Revascularization of a Symptomatic Common Carotid Artery Occlusion

“…The data available for CCA occlusion consist only of case reports and small series, which suggest that good outcomes are possible, although this is certainly affected by publication bias. 2,[7][8][9][10][11][12] Although many surgical revascularization options have been reported, patients who present difficult anatomic circumstances may have worse outcomes, particularly as a result of infrequently performed procedures. 1 Although we acknowledge that blindly passing a guidewire through an occluded vessel that supplies viable brain is unlikely to become a routine procedure, it was believed to represent the best option given the circumstances.…”

“…[7][8][9][10][11][12] This case buttresses the sole existing report that successful endovascular management of an occluded CCA can be accomplished in a symptomatic patient with objective evidence of hemodynamic compromise. 2 In this setting, surgical or endovascular management can be considered if the patient remains refractory to medical therapy. 2,[7][8][9][10][11][12] The site of occlusion in this case was at a distance from the common carotid arterial origin, which, in our opinion, rendered stenting more favorable than for endovascular management of an ostial lesion.…”

“…2 In this setting, surgical or endovascular management can be considered if the patient remains refractory to medical therapy. 2,[7][8][9][10][11][12] The site of occlusion in this case was at a distance from the common carotid arterial origin, which, in our opinion, rendered stenting more favorable than for endovascular management of an ostial lesion. Further studies are required before making recommendations regarding whether CCA occlusion patients should preferentially be managed with surgical, endovascular, or medical paradigms.…”

“…Whether it is appropriate for clinicians to extrapolate ICA occlusion data to the setting of CCA occlusion remains unknown. The data available for CCA occlusion consist only of case reports and small series, which suggest that good outcomes are possible, although this is certainly affected by publication bias 2 7 – 12 Although many surgical revascularization options have been reported, patients who present difficult anatomic circumstances may have worse outcomes, particularly as a result of infrequently performed procedures 1 .…”

“…Successful intervention in the setting of CCA occlusion when required can be accomplished with medical management, with or without a surgical or endovascular procedure. 1,2 Because of the rarity of CCA occlusion, little evidence is available to guide rational decision-making. We present a case of CCA occlusion occurring at a distance from the common carotid arterial origin, which supports the choice of endovascular management for this uncommon problem.…”