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Evolving techniques in the treatment of carotid artery kinking: the use of resected redundant arterial segment.
Gugulakis, A G; Matsagas, M I; Vasdekis, S N; Giannakakis, S G; Lazaris, A M; Sechas, M N.
Afiliación
  • Gugulakis AG; 3rd Surgical Department, School of Medicine, University of Athens, Sotiria Chest Hospital, Greece.
Am Surg ; 67(1): 67-70, 2001 Jan.
Article en En | MEDLINE | ID: mdl-11206900
Internal carotid artery kinking is frequently accompanied by atheromatous disease at the carotid bifurcation, and in this case both lesions may be treated simultaneously. Various surgical techniques have been used to correct carotid kinking but no particular one has been widely established. We conducted a retrospective review of 18 patients operated upon for internal carotid kinking during the last 5 years, which represents 4.1 per cent of the total carotid procedures performed during the same period. In 13 of the 18 patients carotid endarterectomy was performed before the repair of the kink. In four patients resection of the kinked segment with end-to-end anastomosis was performed combined with longitudinal arteriotomy at the carotid bifurcation. Two patients developed restenosis at the site of anastomosis requiring reoperation with patch angioplasty. Three patients were treated with eversion endarterectomy and end-to-side anastomosis, whereas in six patients we performed resection of the redundant internal carotid artery combined with longitudinal arteriotomy at the bifurcation. The posterior wall was reconstructed with interrupted sutures and the procedure was completed with patch angioplasty of the anterior wall. In four of these cases we used the autogenous resected arterial segment as patch material. None of these patients developed restenosis or symptoms in a follow-up period of 3 to 32 months. In cases in which significant carotid artery stenosis and internal carotid kinking coexist resection of the involved segment with end-to-end anastomosis of the posterior wall and patch angioplasty using the resected autogenous arterial segment constitute a convenient and satisfactory method of reconstruction.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arterias / Enfermedades de las Arterias Carótidas / Arteria Carótida Interna / Endarterectomía Carotidea Tipo de estudio: Evaluation_studies / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am Surg Año: 2001 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arterias / Enfermedades de las Arterias Carótidas / Arteria Carótida Interna / Endarterectomía Carotidea Tipo de estudio: Evaluation_studies / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am Surg Año: 2001 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Estados Unidos