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Evaluation of a 44-Year-Old Male with Juvenile Onset Diabetes and Common Carotid Occlusions

A 44-year-old male with juvenile onset type 1 diabetes managed via insulin pump presented for a carotid duplex exam, which revealed common carotid occlusions. The patient has a medical history of hypertension and denies any neurological symptoms or previous cerebrovascular accidents. He was a smoker until two months ago. Upon examination, carotid pulses were nonpalpable, and no bruits were detected. A surgical history includes an upper median sternotomy and the placement of a bifurcated Dacron graft connected to both common carotids.

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Evaluation of a 44-Year-Old Male with Juvenile Onset Diabetes and Common Carotid Occlusions

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  1. History & Physical • 44 yo male with juvenile onset DM who underwent screening carotid duplex exam and found to have B common carotid occlusions. Denies any neurologic symptoms. • PMH: DM (on insulin pump), HTN, no history of CVA/TIA, no CAD • SH: smoker until 2 mo ago • Exam: nonpalpable carotid pulses, no bruits

  2. Upper Median Sternontomy

  3. 12x6 bifurcated Dacron graft taken off the ascending aorta

  4. Graft tunneled beneath innominate vein

  5. Graft sewn to both distal common carotids

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