PMC4976603_01
Computed tomography angiography (CTA), coronal view demonstrated focal stenosis in the right common carotid artery (CCA) (Green arrow) and near occlusion of the proximal left CCA. (Red arrow) (A). Axial view shows focal stenosis in the right internal carotid artery (ICA) (Black hollow arrow) (B).
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American College of Rheumatology criteria (ACR)], and followed in our Institution since 2000 was referred to our vascular surgery clinic with 4 months-history of progressive and frequent episodes of amaurosis fugax in the left eye. A computed tomography angiography (CTA) revealed focal stenotic segments in the right common carotid artery (CCA) and internal carotid artery (ICA); near occlusion of the proximal left CCA was also present (Fig. 1A, B).
A six centimeters (cm) left supraclavicular incision was performed (A); and end to side anastomosis to the subclavian artery was performed using a 6 mm externally supported ePTFE graft (B).
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The patient was taken to the operating room (OR), her neck was turned to the contralateral side and a 6 centimeters (cm) left-sided supraclavicular incision was performed (Fig. 2A). An end-to-side anastomosis was completed in the subclavian artery using a 6-mm ePTFE graft (Fig. 2B).
The graft was passed underneath the sternocleidomastoid muscle (Green Arrow) and the internal jugular vein (Blue arrow) (A), and the anastomosis was completed in an end to side fashion with the left CCA (B).
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Subsequently, an end-to-side anastomosis to the carotid artery was created (Fig. 3A, B).