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10.5606/tgkdc.dergisi.2020.18995
Hybrid approach in tandem high-grade carotid stenoses: A case report
Valentin Govedarski1, Elitsa Dimitrova1, Dimiter Chernev1, Zornitsa Vassileva2
1Department of Vascular Surgery, University Hospital Saint Ekaterina, Sofia, Bulgaria
2Department of Pediatric Cardiology, University National Heart Hospital, Sofia, Bulgaria
DOI : 10.5606/tgkdc.dergisi.2020.18995
A 79-year-old male patient who presented with dizziness
and several syncopal episodes was admitted to our clinic.
Medical history of the patient revealed arterial hypertension
and multifocal atherosclerosis with a history of two ischemic
left middle cerebral artery strokes within the last year, without
residual deficits, two coronary artery bypass grafts 22 years ago,
and Stage IIB peripheral artery disease. The imaging studies
revealed severe stenosis of the left internal carotid artery and
high-grade ostial stenosis of the left common carotid artery.
After clamping of the internal carotid artery and endarterectomy
with patch angioplasty, before the patch was completely sutured,
a sheath was placed through it and dilation and retrograde
stenting of the proximal segment of the left common carotid
artery were performed. The neurological symptoms of the
patient disappeared and on postoperative computed tomography
angiography, there was no residual carotid stenosis.
Keywords : Carotid artery, endovascular, hybrid, tandem stenosis, thromboendarterectomy
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