Figure 3
A patient with long-segment carotid artery occlusion. (A) Cerebral angiography revealed complete occlusion (arrow) of the left carotid artery occlusion. (B) After initial endovascular recanalization failed because a micro-guide wire could not pass through the occluded segment, hybrid surgery was begun with carotid endarterectomy. (C) The initial carotid plaque was removed, but distal organized thrombi could not be removed and was treated with stenting. (D) After intracranial stents were deployed to compress the distal thrombi onto the arterial wall, cerebral angiography revealed patent carotid artery. (E) Immediately after the hybrid surgery, the carotid artery was patent. (F) Eight-month follow-up demonstrated a severe stenosis (arrow) at the stented segment which was treated with expansion of a 3.5× 15 mm balloon catheter without successful recanalization.
