Carotid endarterectomy for non-hemispheric cerebrovascular symptoms: an unusual indication

AK AhChong, CB Law, KM Chiu
Department of Surgery, Kwong Wah Hospital, Waterloo Road, Kowloon, Hong Kong

We report on an 80-year-old man who presented with non-hemispheric cerebrovascular symptoms in the form of daily multiple syncope. The left common carotid artery, its two main divisions, and the right vertebral artery were completely occluded. There was high-grade stenosis in the right carotid artery (82%) and left vertebral artery (60%). After excluding other causes of syncope such as postural hypotension, hypoglycaemia, cardiac arrhythymia, and epileptic seizure, a diagnosis of global ischaemia was made. The patient subsequently underwent carotid endarterectomy and the symptoms were relieved. This case represents an unusual indication for carotid endarterectomy.

Hong Kong Med J 1999;5:391-3

Key words: Carotid arteries/surgery; Cerebrovascular disorders; Endarterectomy; Vertebrobasilar insufficiency; Syncope/etiology