To summarize the technical points of transmidline subclavian artery-common carotid artery bypass through the prevertebral space for the treatment of common carotid artery occlusion, and to evaluate its feasibility and effectiveness.

For a patient with symptomatic left common carotid artery occlusion, right subclavian artery-left common carotid artery artificial blood vessel bypass was performed under general anesthesia. The passage of artificial blood vessel was established through the cervical prevertebral space, and the technical points and surgical effects of this surgical technique for common carotid artery occlusion were summarized.

The operative time of the patient was 205 min and the intraoperative blood loss was 30 ml. After the right subclavicular artery - left common carotid artery artificial vessel bypass through the prevertebral space approach, the left internal carotid artery blood flow was restored and unobtrusive, and there were no postoperative hyperperfusion syndrome and other cerebrovascular complications, and no postoperative complications of neck surgery such as hoarseness, drinking cough, and dysphagia. The patient recovered and was discharged from the hospital 10 days after surgery, and was followed up at 3 months after discharge. The established vascular bypass and left internal carotid artery system were unobstructed. The left cerebral perfusion was improved compared with that before surgery. No cerebral ischemia symptoms such as dizziness and amaurosis occurred again.

Transmidline subclavian artery-common carotid artery bypass through the prevertebral space is feasible and suitable for the treatment of complex common carotid artery occlusion.