Effective surgical treatment of the carotid sinus sindrome

J Cardiovasc Surg (Torino). 2009 Oct;50(5):683-6. Epub 2008 Oct 24.

Abstract

Elderly patients frequently suffer from dizziness and syncope; however, an underlying disease may not always be identified. Three patients aged 69, 71 and 56, respectively, experienced spells of dizziness and syncope. Massage of the carotid sinus demonstrated the presence of a carotid sinus syndrome (CSS), an abnormal baroreflex response of the carotid sinus that leads to asystole and extreme hypotension. Conventional treatment is generally by insertion of a pacemaker. These patients, however, were referred to the vascular surgery department of our hospital for removal of adventitial layers of proximal portions of the internal carotid artery. Recovery was uneventful; all three are now free of symptoms. CSS should be considered in the differential diagnosis of dizziness and syncope. Surgical denervation of the carotid artery is a valid treatment option, especially in the vasodepressive or mixed type of CSS.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autonomic Denervation*
  • Baroreflex
  • Blood Pressure
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / physiopathology
  • Carotid Artery Diseases / surgery*
  • Carotid Artery, Internal / innervation
  • Carotid Artery, Internal / physiopathology
  • Carotid Artery, Internal / surgery*
  • Carotid Sinus / innervation
  • Carotid Sinus / physiopathology
  • Carotid Sinus / surgery*
  • Electrocardiography
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Syncope / etiology
  • Syncope / physiopathology
  • Syncope / surgery*
  • Syndrome
  • Treatment Outcome