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Chirurgia 2016 Giugno;29(3):83-7

lingua: Inglese

Emergency stenting for acute internal carotid artery dissection after carotid endarterectomy with indwelling shunt

Michel BATT 1, Laurent SUISSA 2, Jacques SEDAT 3, Sylvain LACHAUD 2, Yves CHAU 3, Jean BAQUÉ 3

1 Department of Vascular Surgery, St Roch Hospital, Université de Nice, Sophia Antipolis, Nice, France; 2 Department of Vascular Neurology, St Roch Hospital, Université de Nice, Sophia Antipolis, Nice, France; 3 Department of Interventional Neuro‑Radiology and Interventional Vascular Radiology, St Roch Hospital, Université de Nice, Sophia Antipolis, Nice, France


Minimally invasive aortic valve procedures via mini-sternotomy (mini-AVR) are gaining popularity. Myocardial protection in this setting may bA 61-year-old woman underwent right carotid endarterectomy for asymptomatic stenosis (80%). Routine endarterectomy was performed using a selective shunt. The patient recovered from surgery without any neurologic deficit, but six hours after the operation, she experienced massive left-sided hemiplegia. An urgent MRI showed right-sided Sylvian ischemia with an absence of carotid-sylvian flux. Thrombolysis treatment was inadvisable. Lifesaving mechanical unclogging was performed: carotid stenting enabled us to reestablish the permeability of the internal carotid artery and the flux in the middle cerebral artery. Twenty-four hours after the operation, the patient had made a complete neurological recovery.

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