Herbert Oye, D.O., Yahaya Adamu, M.D., Quoc Tran, MSIII, Allie Reed, MS, PA-C.

Transient Ischemic attacks can predispose some patients to major Cerebrovascular accidents (CVA). Usually, some of these patients with Ischemic Strokes have a defined high grade stenosis of the Internal Carotid artery. However, there are some patients with no discernible plaque disease that continually present with TIA symptoms. The only significant CT or Catheter arteriographic findings were significant marked kinking of the internal carotid artery. We report our experience with 2 cases of this phenomenon that were were successfully treated with modified eversion – transposition technique with full resolution of symptoms.

The technique ensures dissection to release the kink and transposition to straighten the Internal Carotid artery. Patients were observed overnight in the Surgical Intensive Care Unit with no post operative complications and full resolution of symptoms noted on outpatient follow up. Eversion-Transposition technique should be considered in patients without significant carotid disease, but flow limiting kinking of the ICA that can produce clinical symptoms of recurrent transient ischemic attacks.