Carotid Endarterectomy in Moyamoya Disease: A Case Report.

We report the case of a 55-year-old female who presented with symptomatic high-grade stenosis of the right internal carotid artery, years after her diagnosis of moyamoya disease (MMD), which had been treated with extensive carotid and cerebral vascular reconstructions. A percutaneous carotid revascularization was unsuccessful, and a carotid endarterectomy with bovine patch angioplasty was subsequently performed. The presence of symptomatic atherosclerotic carotid disease in combination with MMD, with all the perioperative challenges, has not been previously described.