PMC4901814_01
The right lateral view of the internal carotid artery depicted by magnetic resonance angiography volume rendering images. (a) Preoperative magnetic resonance angiography shows the internal carotid artery curved steeply in a medial direction after the stenosis (arrow). (b) Postoperative magnetic resonance angiography shows that the kinked internal carotid artery is properly reconstructed. (c) Magnetic resonance angiography at 1 year after the operation demonstrates that there is no restenosis and that the internal carotid artery shape was preserved
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F1
The cervical ICA showed a strong curved course in the medial direction after the stenotic lesion on magnetic resonance angiography (MRA) [Figure 1a]. Postoperative MRA showed an appropriate course and no kinking of the ICA [Figure 1b]. The ICA shape was preserved at 1 year after the operation [Figure 1c].
The intraoperative findings. (a) The internal carotid artery is kinked after plaque resection (arrow). (b) Fibrinogen-soaked gelatin (arrowheads) is used to reinforce the kinked internal carotid artery. (c) The fixation (arrowheads) in a medial wall of the internal carotid artery is completed with thrombin. (d) The kink is released (arrow)
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F2
After final closure, a distal portion of the ICA was found to have been kinked after removal of the plaque due to the discrepancy in vessel wall thickness [Figure 2].