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Its Importance in the Surgical Management of Extracranial Cerebrovascular Occlusive Disease

John E. Connolly, MD; Edward A. Stemmer, MD

AMA Arch Surg. 1973;106(6):799-802.

Abstract
Patients with completely occluded internal carotid arteries are ordinarily not considered to be candidates for carotid reconstructive surgery. This paper, however, demonstrates the rich anatomical collaterals between the external and internal carotid arteries that become more prominent with internal carotid occlusion. Stenosis of the external carotid in accompaniment with internal carotid occlusion thus becomes a significant lesion.

We have operated on 45 such patients in whom the primary therapeutic procedure was endarterectomy of the external carotid. Additional intracerebral blood flow achieved by opening the external carotid in these patients has resulted in significant beneficial clinical effects. A widely patent external carotid can contribute to increased cerebral flow in the presence of various patterns of intracranial and extracranial occlusive disease.

Author Affiliations
Irvine, Calif

From the Department of Surgery, University of California at Irvine.

Footnotes
Accepted for publication March 2, 1973.

Read before the annual meeting ot the Southern California Chapter of the American College of Surgeons, Long Beach, Calif, Jan 20, 1973.

Reprint requests to Department of Surgery, University of California at Irvine, Irvine, CA 92664 (Dr. Connolly).

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