Bilateral Carotid Stenosis in a Patient with Previous Neck Surgery: Difficulties in Endarterectomy

Carotid stenosis is an important cause of recurrent transient ischemic attacks and stroke. Carotid stenting and endarterectomy are considered equally effective in treating this condition. We report a patient with recurrent TIA and bilateral carotid stenosis who had undergone anterior cervical diskectomy and fusion and who was found to have fibrous bands encasing the right carotid artery. He was treated with endarterectomy on the left side and carotid stenting on the right side. With the widespread availability of procedures like carotid endarterectomy, more older people would undergo this surgery, who might have undergone anterior cervical surgery. Prior neck surgery and adhesions may lead to altered anatomy, risk of increased blood loss, and surgical complications. In such cases, carotid stenting could be an alternative to endarterectomy.