Abstract
Introduction
Stroke is the second
most common cause of cardiovascular mortality. Atherosclerosis is the most
common cause of carotid artery stenosis. The most common site is carotid
bifurcation where the carotid baroreceptors exist and internal carotid artery. The
primary objective of carotid surgery is to protect the brain from an ischemic
damage. In this study, we evaluated early and mid term result of 24 patients
who had undergone unilateral carotid endarterectomy surgery.
Patients,
materials and methods
A total of 24 patients (17 males, 7 females; mean age
68.62 years; ranges from 55 to 91 years) who underwent CEA operations between
January 2015 and january 2017 were retrospectively analyzed. Postoperative
complications (neurological and non-neurological) and mortality were the
primary outcome points in the study. Clinical findings and risk factors were
evaluated.
Results
Among the seven of the
24 NIRS monitored patients (5 males, 2 females; mean age 65.8 years; range 60
to 75 years), a significant decrease in cerebral SO2 was observed during
clamping of the common carotid artery. For this reason we decided to use
intracarotid shunt. We observed that the cerebral oximetry values were
increased after the use of a shunt in these seven cases.
Discussion
NIRS monitoring is a
precious tool which provides vital information and is used to determine whether
a shunt is needed during CEA surgery. The present study showed that carotid
endarterectomy under general anesthesia accompanying NIRS, measurement of the
stump pressure and usage of dacron patch material can be performed with
acceptable mortality and morbidity.
Keywords
References
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- - Ballotta E, Da Giau G, Baracchini C. Carotid endarterectomy contralateral to carotid artery occlusion: analysis from a randomized study. Langenbecks Arch Surg 2002;387:216-21.
- - Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. J Am Coll Cardiol 2011;57:16-94.
- - De Bakey ME. Successfull carotid endarterectomy for cerebrovascular insufficiency: Nineteen-year follow-up. JAMA 1975;233:1083-5.
- - Grego F, Antonello M, Lepidi S, Zaramella M, Galzignan E, Menegolo M, et al. Is contralateral carotid artery occlusion a risk factor for carotid endarterectomy? Ann Vasc Surg 2005;19:882-9.
- - Hidiroglu M, Cetin L, Kunt A, Karakisi O, Kucuker A, Sener O. Early results of carotid endarterectomy for carotid artery diseases. Turkish J Thorac Cardiovasc Surg 2010;18(3):190-195.
- - Liapis CD, Bell PR, Mikhailidis D, Sivenius J, Nicolaides A, Fernandes e Fernandes J, et al. ESVS guidelines. Invasive treatment for carotid stenosis: indications, techniques. Eur Vasc Endovasc Surg 2009;37(4 Suppl):1-19.
- - North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. Engl J Med 1991;325:445-53.
- - Ozdemir N, Nuser CJ, Gabel W. Bilateral karotis darlıklarında cerrahi tedavi ve sonuçları. Turkish J Thorac Cardiovasc Surg 1995;3:211-5.
- - Yildirim T, Akgun S, Sur H, Kinikoglu H, Bilgin F, Arsan S. Short-term results of simultaneous carotid endarterectomy and myocardial revascularization. Turkish J Thorac Cardiovasc Surg 2004;12:156-160.
Abstract
References
- - Aksun M, Girgin S, Kuru V, Şencan A,Yılık L, Aran G et al. Cerebral oximetry monitoring method for the evaluation of the need of shunt placement during carotid endarterectomy. Turkish J Thorac Cardiovasc Surg 2013;21(4):1152-1155.
- - Ballotta E, Da Giau G, Baracchini C. Carotid endarterectomy contralateral to carotid artery occlusion: analysis from a randomized study. Langenbecks Arch Surg 2002;387:216-21.
- - Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. J Am Coll Cardiol 2011;57:16-94.
- - De Bakey ME. Successfull carotid endarterectomy for cerebrovascular insufficiency: Nineteen-year follow-up. JAMA 1975;233:1083-5.
- - Grego F, Antonello M, Lepidi S, Zaramella M, Galzignan E, Menegolo M, et al. Is contralateral carotid artery occlusion a risk factor for carotid endarterectomy? Ann Vasc Surg 2005;19:882-9.
- - Hidiroglu M, Cetin L, Kunt A, Karakisi O, Kucuker A, Sener O. Early results of carotid endarterectomy for carotid artery diseases. Turkish J Thorac Cardiovasc Surg 2010;18(3):190-195.
- - Liapis CD, Bell PR, Mikhailidis D, Sivenius J, Nicolaides A, Fernandes e Fernandes J, et al. ESVS guidelines. Invasive treatment for carotid stenosis: indications, techniques. Eur Vasc Endovasc Surg 2009;37(4 Suppl):1-19.
- - North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. Engl J Med 1991;325:445-53.
- - Ozdemir N, Nuser CJ, Gabel W. Bilateral karotis darlıklarında cerrahi tedavi ve sonuçları. Turkish J Thorac Cardiovasc Surg 1995;3:211-5.
- - Yildirim T, Akgun S, Sur H, Kinikoglu H, Bilgin F, Arsan S. Short-term results of simultaneous carotid endarterectomy and myocardial revascularization. Turkish J Thorac Cardiovasc Surg 2004;12:156-160.
Details
| Journal Section | Surgery Medical Sciences |
|---|---|
| Authors | |
| Publication Date | July 10, 2018 |
| Submission Date | January 5, 2017 |
| Published in Issue | Year 2017 Volume: 34 Issue: 3 |
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