October 1967

Retrograde Thrombectomy for Chronic Occlusion of the Common Carotid Artery

Author Affiliations

San Francisco
From the Surgical Service, Veterans Administration Hospital and the Department of Surgery, University of California School of Medicine, San Francisco.

Arch Surg. 1967;95(4):664-673. doi:10.1001/archsurg.1967.01330160134020

TOTAL occlusion of the common carotid artery is a significant cause of cerebrovascular insufficiency.1-4 This lesion has been found in from 3% to 20% of all patients who have symptoms caused by extracranial vascular disease.1-6 In our series this lesion occurred in 5% of the patients. Surgical repair of occlusion of the common carotid artery requires an operation of considerable magnitude, compared to the local procedure used for lesions of the internal carotid.

The standard technique used to restore circulation after common carotid occlusion involves a simultaneous thoracic and cervical approach. Once the vessel is exposed proximal and distal to the occlusion, a thromboendarterectomy or a bypass graft is used to restore circulation.1-4,6-9 An alternative, less extensive approach involves a bypass graft from the ipsilateral subclavian artery to the carotid bifurcation.2 With the exception of the latter procedure, repair of a totally occluded common carotid artery

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