J.Jpn. Surg. Soc.. 83(10): 1257-1261, 1982
Original article
A CASE REPORT OF RECONSTRUCTIVE SURGERY FOR STENOSIS OF RIGHT INTERNAL CAROTID ARTERY AND RIGHT VERTEBRAL ARTERY
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Department of Surgery, Kenritsu Owari Hospital Teruo lkezawa, Syoji Maeda, Kazuto Nakagami, Naokazu Hayakawa, Yukifumi Nakata |
Recently we met a 54 year-old male who complained of dizziness and mild left hemiplegia for a short time before admission, and was submitted to cervical arteriography by Seldinger’s method, which showed stenosis of the right internal carotid artery and the proximal end of the right vertebral artery. Then he was diagnosed ischemic cerebrovascular disease caused by stenosis of these two arteries. At first, he was subjected to right carotid endarterectomy. After the operation, dizziness and mild left hemiplegia were improved, but tendancy to walk to the left direction contrary to his intention to go straight had remained. Therefor, three months after the first operation, reconstructive surgery of the right vertebral artery was performed. After the second operation, he complained of no symptoms. Postoperative course has been uneventful. We discuss the diagnosis and the treatment of these lesions.
By the way, there have been many procedures to protect the brain from ischemia because the carotid artery is clamped during reconstructive surgery. Recently internal shunt is the most commonly used. Although some people dislike to use internal shunt because of its troublesomeness and possible postoperative cerebral infarction, we think it better to use internal shunt steadily to protect the brain from ischemia.
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