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Skull base surgery. 1994 April; 4(2): 110–115.
PMCID: PMC1656476

Distal Cervical Internal Carotid Artery Stenosis


This report describes a case of distal cervical internal carotid artery (ICA) occlusive lesion managed by saphenous interposition vein graft after exposure of the ICA up to the skull base. The skull base approach described herein emphasizes the mobilization of the mandible without mandibular osteotomy or disarticulation. Instead, the stylomandibular and stylosphenoidal ligaments are resected to allow mandibular mobilization. In addition, the distal ICA lesion represented a form of diffuse intimal thickening without any plaque formation. This required the resection of the thickened, stenotic segment and reconstruction of the distal cervical ICA with a saphenous interposition graft. The surgical management implications of diffuse intimal thickening are discussed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • SCHWARTZ CJ, MITCHELL JR. Observations on localization of arterial plaques. Circ Res. 1962 Jul;11:63–73. [PubMed]
  • Solberg LA, Eggen DA. Localization and sequence of development of atherosclerotic lesions in the carotid and vertebral arteries. Circulation. 1971 May;43(5):711–724. [PubMed]
  • Sundt TM, Jr, Pearson BW, Piepgras DG, Houser OW, Mokri B. Surgical management of aneurysms of the distal extracranial internal carotid artery. J Neurosurg. 1986 Feb;64(2):169–182. [PubMed]
  • Batzdorf U, Gregorius FK. Surgical exposure of the high cervical carotid artery: experimental study and review. Neurosurgery. 1983 Dec;13(6):657–661. [PubMed]
  • Balagura S, Carter JB, Gossett DL. Surgical approach to the high subcranial internal carotid artery. Neurosurgery. 1985 Mar;16(3):402–405. [PubMed]
  • Sekhar LN, Schramm VL, Jr, Jones NF, Yonas H, Horton J, Latchaw RE, Curtin H. Operative exposure and management of the petrous and upper cervical internal carotid artery. Neurosurgery. 1986 Dec;19(6):967–982. [PubMed]
  • Fisch UP, Oldring DJ, Senning A. Surgical therapy of internal carotid artery lesions of the skull base and temporal bone. Otolaryngol Head Neck Surg (1979) 1980 Sep-Oct;88(5):548–554. [PubMed]
  • Purdue GF, Pellegrini RV, Arena S. Aneurysms of the high internal carotid artery: a new approach. Surgery. 1981 Feb;89(2):268–270. [PubMed]
  • Roederer GO, Langlois YE, Chan AR, Chikos PM, Thiele BL, Strandness DE., Jr Is siphon disease important in predicting outcome of carotid endarterectomy? Arch Surg. 1983 Oct;118(10):1177–1181. [PubMed]
  • Craig DR, Meguro K, Watridge C, Robertson JT, Barnett HJ, Fox AJ. Intracranial internal carotid artery stenosis. Stroke. 1982 Nov-Dec;13(6):825–828. [PubMed]
  • Ojemann RG, Crowell RM, Roberson GH, Fisher CM. Surgical treatment of extracranial carotid occlusive disease. Clin Neurosurg. 1975;22:214–263. [PubMed]
  • BEALL AC, Jr, CRAWFORD ES, COOLEY DA, DeBAKEY ME. Extracranial aneurysms of the carotid artery. Report of seven cases. Postgrad Med. 1962 Aug;32:93–102. [PubMed]
  • DePalma RG. Optimal exposure of the internal carotid artery for endarterectomy. Surg Gynecol Obstet. 1977 Feb;144(2):249–250. [PubMed]
  • HARDIN CA. Cervical aneurysms and tumors. Management of cases requiring resection and restoration of the carotid artery. Arch Surg. 1961 Mar;82:435–439. [PubMed]
  • WILENS SL. The nature of diffuse intimal thickening of arteries. Am J Pathol. 1951 Sep-Oct;27(5):825–839. [PubMed]

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