Recanalization of chronic occlusion of the common carotid artery (CCA) in patients with a history of neck irradiation is challenging, both for vascular surgeons and interventional neuroradiologists. We describe a case of successful stenting of radio induced chronic occlusion of the right CCA in a 41-year-old patient with neurological deterioration and minor stroke due to cerebral hypoperfusion caused by concomitant bilateral arterial occlusions. Direct surgery and surgical bypass were considered contraindicated. The endovascular approach was successful and required multiple precautions during the procedure. We describe particular solutions, not used in day to day practice, that allowed us to carry out the endovascular treatment in this unusual situation.
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Republished with permission from BMJ Case Reports Published 1 November 2016; doi:10.1136/bcr-2016-012722
Contributors LN: substantial contributions to the intellectual content, conception and design of the study, and drafting of the manuscript; substantial contributions to the literature review; and critical revision of the manuscript. FC: critical revision of the manuscript for important intellectual content and final approval of the submitted manuscript for which he takes public responsibility for the whole content. GC, FV, and CB: acquisition of the data, and analysis and interpretation of the data. All authors read and approved the final manuscript.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.