The role of external carotid revascularization in the treatment of ocular ischemia

Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are established cerebrovascular procedures to reduce risk of stroke. Complications include stroke, myocardial infarction, and death. A delayed complication following carotid revascularization is cerebral hyperperfusion syndrome (CHS), which can manifest as intracerebral hemorrhage (ICH)[1]. A less common delayed complication of carotid revascularization procedures is reversible cerebral vasoconstriction syndrome (RCVS).

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Cervical carotid revascularization: the role of angioplasty with stenting

Neurosurgery Clinics of North America ◽

10.1016/j.nec.2004.08.005 ◽

2005 ◽

Vol 16 (2) ◽

pp. 263-278 ◽

Cited By ~ 4

Author(s):

Ricardo A. Hanel ◽

Elad I. Levy ◽

Lee R. Guterman ◽

L. Nelson Hopkins

Keyword(s):

Carotid Revascularization

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Embolization of Bleeding Pinna Arteriovenous Malformation after Ligation of the External Carotid Artery: A Therapeutic Challenge

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0037-1609044 ◽

2017 ◽

Vol 01 (03) ◽

pp. 184-189

Author(s):

Rahul Kumar ◽

Ankur Goyal ◽

Ashu Bhalla ◽

Sonia Sandip ◽

Kapil Sikka

Keyword(s):

Carotid Artery ◽

Arteriovenous Malformation ◽

Percutaneous Treatment ◽

Endovascular Embolization ◽

External Carotid Artery ◽

External Carotid ◽

Resonance Imaging ◽

Percutaneous Embolization ◽

History Of

AbstractA 25-year-old patient presented with bleeding of right pinna arteriovenous malformation (AVM). There was history of ipsilateral external carotid artery (ECA) ligation 10 years back. Subsequent investigations (ultrasound, magnetic resonance imaging, digital subtraction angiography) showed recruitment of complex collaterals from the ipsilateral subclavian artery and vertebral artery feeding the recurrent nidus. The patient underwent two sessions of endovascular embolization and one session of percutaneous embolization. We wish to highlight the feasibility of antegrade embolization in such cases via collaterals and role of direct percutaneous treatment.

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Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association

Circulation ◽

10.1161/cir.0000000000000968 ◽

2021 ◽

Author(s):

Curtis Benesch ◽

Laurent G. Glance ◽

Colin P. Derdeyn ◽

Lee A. Fleisher ◽

Robert G. Holloway ◽

...

Keyword(s):

Intravenous Thrombolysis ◽

Heart Association ◽

Pressure Control ◽

Neurological Dysfunction ◽

Anesthetic Technique ◽

Perioperative Stroke ◽

Carotid Revascularization ◽

Preoperative Optimization ◽

Scientific Statement

Perioperative stroke is a potentially devastating complication in patients undergoing noncardiac, nonneurological surgery. This scientific statement summarizes established risk factors for perioperative stroke, preoperative and intraoperative strategies to mitigate the risk of stroke, suggestions for postoperative assessments, and treatment approaches for minimizing permanent neurological dysfunction in patients who experience a perioperative stroke. The first section focuses on preoperative optimization, including the role of preoperative carotid revascularization in patients with high-grade carotid stenosis and delaying surgery in patients with recent strokes. The second section reviews intraoperative strategies to reduce the risk of stroke, focusing on blood pressure control, perioperative goal-directed therapy, blood transfusion, and anesthetic technique. Finally, this statement presents strategies for the evaluation and treatment of patients with suspected postoperative strokes and, in particular, highlights the value of rapid recognition of strokes and the early use of intravenous thrombolysis and mechanical embolectomy in appropriate patients.

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