{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:10:34Z","timestamp":1763111434365,"version":"3.45.0"},"reference-count":16,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cerebral ischemia associated with common carotid artery (CCA) occlusion is a relatively rare condition, and the optimal surgical strategy remains controversial, with no established consensus. Herein, we report the first case of carotid endarterectomy combined with balloon thrombectomy for proximal CCA occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Case Description:<\/jats:title>\n                    <jats:p>The patient was a 66-year-old male with orthostatic hypotension after C4 spinal cord injury who presented with posture-induced right hemiparesis and aphasia. Magnetic resonance imaging revealed left CCA occlusion proximally to the clavicle. Arterial spin labeling revealed a significant reduction in cerebral blood flow in the left hemisphere. In light of the emergence of new cerebral infarctions despite maximal medical therapy, surgical revascularization was deemed necessary. During the actual surgical procedure, recanalization was successfully achieved by advancing a balloon catheter through the arteriotomy and retrieving the thrombus. No complications occurred, and the patient experienced neurological improvement, being discharged to a rehabilitation facility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This combined technique is less invasive and feasible for treating CCA occlusion located in anatomically challenging regions below the clavicle.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_1036_2025","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:06:42Z","timestamp":1763111202000},"page":"477","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Less invasive carotid endarterectomy with balloon thrombectomy for proximal common carotid artery occlusion in a patient with C4 spinal cord Injury: A case report"],"prefix":"10.25259","volume":"16","author":[{"given":"Mao","family":"Yamamoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masafumi","family":"Segawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sho","family":"Tsunoda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Kawashima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuichi","family":"Noda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuya","family":"Akabane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"10.25259\/SNI_1036_2025\/ref-1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1055\/s-0035-1547340","article-title":"Common carotid artery occlusion: A single-center experience in 40 cases","volume":"25","author":"Belczak","year":"2015","journal-title":"Int J Angiol"},{"key":"10.25259\/SNI_1036_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/0741-5214(93)90672-9","article-title":"Common carotid artery occlusion with patent internal and external carotid arteries: Diagnosis and surgical management","volume":"17","author":"Belkin","year":"1993","journal-title":"J Vasc Surg"},{"key":"10.25259\/SNI_1036_2025\/ref-3","doi-asserted-by":"crossref","first-page":"105143","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105143","article-title":"Comparison of the effectiveness of ring-stripping retrograde endarterectomy and carotid artery crossover bypass in the treatment of patients with symptomatic riles type 1A common carotid artery occlusion","volume":"29","author":"Chen","year":"2020","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_1036_2025\/ref-4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1590\/S1516-31802002000500007","article-title":"Ring-stripping retrograde common carotid endarterectomy: Case report","volume":"120","author":"De Aguiar","year":"2002","journal-title":"Sao Paulo Med J"},{"key":"10.25259\/SNI_1036_2025\/ref-5","first-page":"241","article-title":"A method for extraction of arterial emboli and thrombi","volume":"116","author":"Fogarty","year":"1963","journal-title":"Surg Gynecol Obstet"},{"key":"10.25259\/SNI_1036_2025\/ref-6","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/00000658-196503000-00001","article-title":"Catheter technic for arterial embolectomy","volume":"161","author":"Fogarty","year":"1965","journal-title":"Ann Surg"},{"key":"10.25259\/SNI_1036_2025\/ref-7","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1161\/CIRCOUTCOMES.109.850842","article-title":"Complication rates after left-versus right-sided carotid endarterectomy","volume":"2","author":"Girard","year":"2009","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"10.25259\/SNI_1036_2025\/ref-8","first-page":"1","article-title":"Autoregulation of cerebral blood flow in patients with orthostatic hypotension after spinal cord injury","volume":"29","author":"Gonzalez","year":"1991","journal-title":"Paraplegia"},{"key":"10.25259\/SNI_1036_2025\/ref-9","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1001\/jama.1968.03140110053011","article-title":"Joint study of extracranial arterial occlusion. 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