Supra-aortic stenosis surgery: case study

The aim of this study was to demonstrate a case of aorto-carotid bypass in a patient with carotid artery stenosis as a reasonable and necessary method for preventing ischemic stroke. The study was conducted at the University Hospital Center “Mother Teresa” (QSUT), Tirana. A 63-year-old patient with atherosclerotic arteriopathy and hypertension presented with episodes of dizziness and syncope. Doppler echocardiography revealed an increase in blood flow velocity in the right and left carotid arteries by more than 2.5 times. Computed tomography angiography visualised stenosis of the right and left common carotid arteries, stenosis of the brachiocephalic trunk at the beginning, and occlusion of the left subclavian artery. Performed revascularization of the common carotid arteries using a bifurcated 14×7 mm Dacron graft. The proximal end of the graft was anastomosed to the ascending aorta, and the distal ends were connected to both common carotid arteries. Follow-up Doppler echocardiography showed normalization of blood flow velocity in the carotid arteries. The patient’s neurological symptoms completely disappeared. The patient was discharged without complications after 10 days. The method of resolving complex multisegmental stenosis by aorto-carotid bypass ensures optimal perfusion of the brain and is proposed for use in appropriate conditions for the prevention of ischemic stroke.