Effective surgical treatment of the carotid sinus sindrome
Toorop, R.J.; Scheltinga, M.R.M.; Bender, M.H.M.; Charbon, J.A.; Huige, M.C.; Moll, F.L.; Bruijninckx, C.M.A.
Journal of Cardiovascular Surgery 50(5): 683-686
2009
ISSN/ISBN: 0021-9509 PMID: 18948872 Document Number: 628838
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.