Common carotid artery (CCA) occlusion with patency of the internal carotid artery (ICA) is a rare cause of stroke with no consensus on optimal management.1 Open surgery, most often CCA-subclavian or CCA-aortic arch bypass techniques, have been used to recanalize short proximal occlusions.1 2 Endovascular revascularization of chronic total ICA occlusion was proposed with promising results in previous reports.3–5 However, endovascular recanalization for chronic CCA occlusion has rarely been described in the literature, and the reports involved mainly right-sided occlusions or occlusions with residual CCA stumps.6 Anterograde endovascular management of chronic long left-sided CCA occlusions is problematic due to lack of support, notably when no proximal stump is present.4 In this video, we present a case of known long-chronic CCA occlusion managed by retrograde echo-guided ICA puncture and stent-assisted reconstruction.(video 1)
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Contributors RAR and FC contributed equally. RAR: narration, acquisition of images and videos, creation of the video, revising, and final approval. FC: drafting, revising, creation of the video, and final approval of the video. ID: revising, acquisition of images and videos, final approval of the video. VC: performing the surgical procedure and final approval of the video. GG: performing the surgical procedure and final approval of the video. All authors acknowledge that they are accountable for all aspects of the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.