ABSTRACT
There is abundant evidence that patients with occlusion of the internal carotid artery have the potential for ipsilateral hemispheric or ocular symptoms due either to thromboemboli passing through natural connections between the external and internal carotid arteries or to hemodynamic abnormalities from reduced blood flow.[1-3] In certain situations, operation on the carotid bifurcation which both removes atherosclerotic plaque and remodels the stump of the occluded internal carotid artery, producing a smooth tapering of the common carotid artery into the external carotid artery, can prevent these symptoms. In a similar fashion, patients with diseased or occluded external carotid arteries can suffer thromboembolic events through an open internal carotid. Endarterectomy or remodeling of the stump of the diseased external carotid artery can similarly relieve such symptoms and prevent late stroke.
