Evaluation of revascularization after total arch replacement in common carotid artery occlusion
Evaluation of revascularization after total arch replacement in common carotid artery occlusion作者机构：Department of Cardiovascular Surgery Kobe City Medical Center General Hospital
出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)
年 卷 期：2018年第6卷第1期
页 面：6-10页
核心收录：
主 题：Color duplex sonography Common carotid artery occlusion Revascularization Single-photon emission computed tomography Total arch replacement
摘 要：Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography(SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow(the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.
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