Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492007000300012
Jornal Vascular Brasileiro
Case Report

Recanalização espontânea tardia de carótida interna: relato de caso

Late spontaneous recanalization of internal carotid artery: case report

Glauco Fernandes Saes; Tiago Calheiros H. Barbosa; Jocefábia Reika Lopes; Afonso César Polimanti; Rafael Noronha Cavalcante; Maria Alice Bosch; João Corrêa; Ohannes Kafejian

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Resumo

A recanalização espontânea tardia da carótida interna é um evento incomum e pouco estudado. Os autores relatam o caso de paciente de 73 anos, masculino, hipertenso, com antecedente de acidente vascular cerebral há 3 anos, com seqüela motora e sensitiva em membro superior direito, apresentando ao mapeamento dúplex e arteriografia oclusão total da carótida interna. Evoluiu após 2 anos com novos episódios de ataques isquêmicos transitórios de repetição. Submetido a novos exames de imagem para avaliação da circulação cerebral extra e intracraniana, evidenciou-se recanalização do vaso, com estenose severa. Foi realizada endarterectomia de carótida esquerda, sem intercorrências. Paciente evoluiu sem novos episódios após 1 mês de seguimento. Considerando a raridade do caso e a parca literatura sobre recanalização tardia de carótida, passível de reparo cirúrgico, optamos pela apresentação do caso enfocando a importância do acompanhamento de oclusões carotídeas.

Palavras-chave

Estenose carotídea, estenose carotídea, remissão espontânea, artéria carótida interna, angiografia cerebral, acidente vascular cerebral, acidente cerebrovascular

Abstract

Late spontaneous recanalization of internal carotid artery is an unusual event that has received little attention. The authors report a case of a 73-year-old male patient, hypertensive, with previous history of cerebral vascular accident 3 years ago, with sensorimotor sequela in the right upper limb. Duplex scanning and arteriography showed total occlusion of the internal carotid artery. The patient progressed after 2 years with new episodes of recurrent transient ischemic attacks. When submitted to new imaging examinations to assess extra- and intracranial circulation, vessel recanalization was demonstrated, with severe stenosis. Left carotid endarterectomy was uneventfully performed. The patient progressed without new episodes after a 1-month follow-up. Considering the case rarity and the lack of literature on late carotid artery recanalization that can be surgically repaired, we decided to present this case focusing on the importance of following carotid artery occlusions.

Keywords

Carotid artery stenosis, carotid artery stenosis, spontaneous remission, internal carotid artery, cerebral angiography, stroke

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