Hybrid surgery for symptomatic chronic complete occlusion of the internal carotid artery: A case report

Currently, there are antiplatelet drugs, extracranial-intracranial(EC-IC) vascular bypass, carotid endarterectomy(CEA), endovascular intervention(EI), and other revascularization procedures for symptomatic chronic internal carotid artery occlusion(CICAO). In consulting the literature, we found that existing techniques for single treatments cannot achieve satisfactory results when there is a long segment occlusion with plaque attached to the intracranial segment and a short stump at the initial segment. We reported the case of a 50-year-old male patient with blurred vision, headache, and weakness in the right upper limb. After the exclusion of other neurological diseases, he was diagnosed with symptomatic CICAO; the occlusion segment was long and the stump was too short. We performed a novel hybrid surgery for the patient—a carotid endarterectomy combined with internal carotid artery stenting. After 6 months of follow-up, computed tomography angiography(CTA) confirmed that the left internal carotid artery was unobstructed, and the symptoms were relieved. A brief review of the literature is presented in addition to this report.