In the past 14 years, 22 patients (25 operated sides), with occlusion of the internal carotid artery (ICA), underwent ipsilateral external carotid artery (ECA) endarterectomy at our institution. Operative indications were amaurosis fugax in 13 sides and nonlateralizing transient ischemic attacks in the remaining 12. There were no operative deaths. One patient suffered a minor stroke after operation. Follow-up ranged from 6 to 110 months (median 36 months). In 16 cases, simple endarterectomy with or without vein patch closure was performed (type I). In two cases the ostium of the ICA was occluded with interrupted sutures after endarterectomy (type II). In the remaining seven cases the ICA was transposed as a patch over the endarterectomized ECA after endarterectomy (type III). All but six patients (six sides) underwent duplex scanning or angiography during follow-up. Four of nine patients with previous nonlateralizing symptoms had persistent symptoms after operation, whereas none of those with previous amaurosis fugax did. Recurrent occlusive disease was more common in type I reconstructions (p less than 0.05). Proper ECA reconstruction results in long-term patency. In the patient with ipsilateral ICA occlusion, transposition of the ICA as a patch over the endarterectomized ECA offers a valid hemodynamic solution. Objective parameters are needed to identify patients with nonlateralizing symptoms who will benefit from operation.

External carotid endarterectomy: indications, technique, and late results / Sterpetti, A V; Schultz, R D; Feldhaus, R J. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - 7:1(1988), pp. 31-9-39. [10.1067/mva.1988.avs0070031]

External carotid endarterectomy: indications, technique, and late results

Sterpetti, A V
Primo
Conceptualization
;
1988

Abstract

In the past 14 years, 22 patients (25 operated sides), with occlusion of the internal carotid artery (ICA), underwent ipsilateral external carotid artery (ECA) endarterectomy at our institution. Operative indications were amaurosis fugax in 13 sides and nonlateralizing transient ischemic attacks in the remaining 12. There were no operative deaths. One patient suffered a minor stroke after operation. Follow-up ranged from 6 to 110 months (median 36 months). In 16 cases, simple endarterectomy with or without vein patch closure was performed (type I). In two cases the ostium of the ICA was occluded with interrupted sutures after endarterectomy (type II). In the remaining seven cases the ICA was transposed as a patch over the endarterectomized ECA after endarterectomy (type III). All but six patients (six sides) underwent duplex scanning or angiography during follow-up. Four of nine patients with previous nonlateralizing symptoms had persistent symptoms after operation, whereas none of those with previous amaurosis fugax did. Recurrent occlusive disease was more common in type I reconstructions (p less than 0.05). Proper ECA reconstruction results in long-term patency. In the patient with ipsilateral ICA occlusion, transposition of the ICA as a patch over the endarterectomized ECA offers a valid hemodynamic solution. Objective parameters are needed to identify patients with nonlateralizing symptoms who will benefit from operation.
1988
Aged; Arterial Occlusive Diseases; Carotid Artery Diseases; Carotid Artery, External; Endarterectomy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Recurrence; Time Factors
01 Pubblicazione su rivista::01a Articolo in rivista
External carotid endarterectomy: indications, technique, and late results / Sterpetti, A V; Schultz, R D; Feldhaus, R J. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - 7:1(1988), pp. 31-9-39. [10.1067/mva.1988.avs0070031]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1442174
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