An up-close look at the result of a rare procedure
By Behzad Farivar, MD, and Sean Lyden, MD
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
The resected atherosclerotic carotid artery stent shown above was recently removed from a patient who had undergone a carotid endarterectomy in 1994 and then had a carotid stent placed in 2004 for recurrent carotid stenosis. The earlier procedures were done at outside institutions, but the patient was referred to Cleveland Clinic’s Department of Vascular Surgery at age 63 for greater than 90 percent stenosis within her stent, attributable to atherosclerosis.
We resected her carotid artery, including the stent with atherosclerotic plaque, and did an interposition bypass. This is a complex reoperative procedure that is not commonly performed due to a significant risk of nerve injury and stroke. The patient was at particularly high risk due to significant comorbidities including diabetes, chronic kidney disease and peripheral artery disease. Despite these risks, the danger of stroke was sufficiently great to justify the procedure, and the patient has fared very well since the surgery over one month ago. She has resumed all her activities from before without any limitations. She is now scheduled for routine follow-up at six months with carotid duplex ultrasound surveillance.
Drs. Farivar and Lyden are surgeons in Cleveland Clinic’s Department of Vascular Surgery.
Excessive dynamic airway collapse presenting as dyspnea and exercise intolerance in a 67-year-old
Young man saved multiple times by rapid collaborative response
Necessity breeds innovation when patient doesn’t qualify for standard treatment or trials
After optimized medical and device therapy, is there a role for endocardial-epicardial VT ablation?
Fever and aortic root bleeding two decades post-Ross procedure
How to time the interventions, and how to manage anesthesia risks?
A potentially definitive repair in a young woman with multiple prior surgeries
Matching the minimally invasive CABG alternative to the right candidates