ABSTRACT
These AP (A) and lateral (B) radiographs demonstrate a patient with a symptomatic stenosis of the common and internal carotid arteries and a concurrent occlusion, presumably atherosclerotic, of the ECA. At surgery, these ECAs can occasionally be reopened with removal of the plaque. Although an ECA occlusion by itself is of little consequence, it is important to recognize this variant because if it is not possible to surgically reopen the ECA, the stroke risk is somewhat increased, the reason being that at the conclusion of the surgical procedure, when the clamps are removed, there is no ECA safety valve through which air and debris can be flushed before reopening the ICA. The subject is discussed further in Part 3: Surgical Technique, in the section dealing with the sequence of clamp removal. (See Fig. 3-76.)
