Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2018; 6(1): 6-10
Published online Jan 16, 2018. doi: 10.12998/wjcc.v6.i1.6
Evaluation of revascularization after total arch replacement in common carotid artery occlusion
Yasuhiro Matsuda, Tadaaki Koyama
Yasuhiro Matsuda, Tadaaki Koyama, Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Hyogo 650-0047, Japan
Author contributions: Matsuda Y and Koyama T designed the report and wrote the paper.
Informed consent statement: Written informed consents were obtained from the patient.
Conflict-of-interest statement: We certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Yasuhiro Matsuda, MD, Surgeon, the Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Kobe City, Hyogo 650-0047, Japan.
Telephone: +81-78-3021234 Fax: +81-78-3027537
Received: November 11, 2017
Peer-review started: November 17, 2017
First decision: November 30, 2017
Revised: December 6, 2017
Accepted: December 14, 2017
Article in press: December 15, 2017
Published online: January 16, 2018
Case characteristics

An 80-year-old man with a cystic thoracic aneurysm of the arch was performed total arch replacement.

Clinical diagnosis

Drowsiness and right hemiplegia related to emboli after total arch replacement.

Differential diagnosis

Embolism, thrombosis, aorta dissection, infection.

Imaging diagnosis

Single-photon emission computed tomography showed the left cerebral flow was low.


The authors performed bypass of the left subclavian artery to the left common carotid artery (CCA).

Related reports

Martin RS 3rd reported indications for surgical treatments for CCA occlusion.

Experience and lessons

Patients with CCA occlusion who continue to have neurological symptoms should be assessed both the blood flow and the brain perfusion.