Recurrent carotid stenosis or false aneurysm. A simple approach.
The advantages of this method appear to be (1) minimal dissection in the area of previous surgery or aneurysm; (2) high exposure of the upper portion of the internal carotid artery, avoiding damage to the vagus and hypoglossal nerves, plus good exposure and control in a clean area; (3) easy shunting that facilitates the distal anastomosis as well as protects the brain; (4) proper length of the graft is assured by stretching it down the shunt and slitting it to the level of the upper end of the common carotid arteriotomy, (5) no dissection is necessary to preserve the external carotid, and it is not necessary to clamp this vessel; (6) intraluminal ligation of the external carotid artery after reconstruction in the case of aneurysm prevents unnecessary dissection.