Plication for Correction of Excessive Carotid Artery Kinking, Unacceptable Torn End Point, and Perforation from Plaque Erosion: Techniques and Results

The purpose of this study was to introduce carotid plication as a simpler alternative approach to internal carotid resection, reimplantation, graft replacement in the management of symptomatic carotid kink, carotid perforation, and unacceptable end point. Fifty-two carotid plications (internal carotid = 49, common carotid = three) were performed on 50 patients (29 men, 21 women) and followed up for 8-129 months (mean 67). Carotid plications were performed for kink (n: 43), carotid perforation from plaque erosion (n: three), and unacceptable end point of endarterectomy (n: six). The operation was performed with 100% shunting and vein patch angioplasty. There was no death, stroke, aneurysm, pseudoaneurysm, rupture, or stenosis in the 52 carotid plications. Symptomatic relief was successful in amaurosis fugax, transient ischemic attack, global ischemia, and vertebral-basilar symptoms. Only partial relief was achieved in carotid throbbing. Carotid plication is a simple, dependable, and durable procedure for symptomatic carotid kink, carotid perforation due to plaque erosion not amendable to lateral repair, and unacceptable distal end point in carotid endarterectomy.