Combined vascular reconstruction of long segment cervical internal carotid artery stenosis

We report a case treated successfully by carotid endarterectomy (CEA) combined with balloon PTA of a long severe stenotic lesion of the internal carotid artery (ICA). A 77-year-old male was admitted with brain infarction. Carotid angiography showed a long stenotic lesion from the origin to the petrous portion of the ICA. Immediately after standard CEA, balloon percutaneous transluminal angioplasty (PTA) using intraoperative digital subtraction angiography (DSA) was performed for treating the residual distal stenotic lesion. Histopathological findings showed that newly formed vessels in the atheromatous plaque indicated recanalization of the occluded ICA. Well-planned surgery and endovascular techniques can be complementary in the management of patients suffering from such long stenotic lesions of the ICA.