From January 1985 to October 1992 ten patients were submitted to reconstruction of the external carotid artery (ECA). Nine were males and one female with age that ranged from 64 to 74 years, mean 68. All were symptomatic due to TIAs in seven and
amaurosis fugax in four of this group, previous completed
stroke plus TIAs in two and chronic low perfusion in one. Associated risk factors were smoking (8 pts: 80%),
coronary disease (5 pts: 50%),
hypertension (4 pts: 40%), diabetes (4 pts: 40%) and peripheral
arterial obstructive disease (2 pts: 20%). All patients were submitted to non invasive (Doppler C. W., Echo-color Doppler) studies as well as angiography. All the patients had an occlusion of the internal carotid artery (ICA) unilateral and homolateral to external
carotid stenosis in 8 and bilateral in 2; in addition three patients had a non haemodynamic
stenosis of the contralateral ICA. One patient had an occlusion of the common carotid artery with collateral supply to the ECA; nine had severe
stenosis of the ECA at the origin. In one case a homolateral vertebral
stenosis was detected as well as a prevertebral contralateral subclavian
stenosis in another one. Surgery was advised to correct
amaurosis fugax, to increase external-internal collateral supply in order to avoid cerebral ischaemia and prior to contralateral ICA
endarterectomy. All patients were operated upon under
general anesthesia; an
endarterectomy with a
PTFE patch was performed in 9 cases, while in one a subclavian-ECA bypass was carried out using an autologous vein segment.(ABSTRACT TRUNCATED AT 250 WORDS)