External carotid endarterectomy for amaurosis fugax in the presence of internal carotid artery occlusion

Two patients with occlusion of the internal carotid artery who were experiencing repeated episodes of transient monocular blindness in the ipsilateral eye were successfully treated with external carotid endarterectomy. The mechanisms for the production of symptoms in the presence of an internal carotid occlusion are discussed, including the anatomical pathways for embolization through collaterals between the internal and external carotid arteries. The indications, technique and results of external carotid endarterectomy are reviewed