External carotid artery reconstruction: Its role in the treatment of cerebral ischemia

Flow Velocities in the External Carotid Artery Following Carotid Revascularization

“…The exact clinical impact of stenosis of the ECA, however, remains unclear. 16,17 There have however been case reports that describe plaque in the ECA which served as a source of emboli into the internal carotid circulation. 18 To our knowledge no other randomized study of stenting versus endarterectomy has analyzed the fate of the ECA after carotid revascularization.…”

The Fate of the External Carotid Artery after Carotid Artery Stenting. A Follow-up Study with Duplex Ultrasonography

“…10 Others doubt if the contribution of the ECA collaterals to cerebral perfusion is substantial. 11,12 Still, many surgeons routinely perform some kind of ECA endarterectomy during standard CEA, 2 to preserve ECA patency and hereby collateral supply in cerebral perfusion in the event of recurrent ICA stenosis. Management of ECA stenosis during routine CEA is however controversial, in part because of high residual stenosis rate as well as early and late recurrent stenosis rate.…”

Carotid thromboendarterectomy for recent total occlusion of the internal carotid artery

“…[4][5][6][7]13 Although some patients with occlusion of the ICA can have a catastrophic brain injury, others have only a TIA or Strokes and TIAs after total occlusion of the ICA have been attributed to four main pathogenic mechanisms: (1) emboli into the circle of Willis from the distal end of the occlusive thrombus; (2) emboli originating from a residual internal artery stump through the ECA; (3) emboli from ipsilateral CCA, ECA, or aorta through collateral channels; or most likely, (4) hypoperfusion distal to the occlusion. 13,[16][17][18][19] The capacity of the cerebral circulation to develop collateral flow depends on autoregulation, which is dependent on native cerebral collateral anatomy. Impairment of autoregulation leads to chronic cerebral hypoperfusion, and therefore, neurologic function becomes susceptible to changes in blood pressure and cardiac output.…”