Threatening of cerebrovascular insufficiency within surgery of carotid artery restenosis

• Authors: Stefan Palkovic , Tonny Tjan , Bernhard Fischer , Hansdetlef Wassmann
• Languages of publication: EN

Abstracts

EN

Surgical intervention for extracranial carotid artery stenosis remains a major potential therapeutic modality for the prevention of stroke. Nevertheless, every kind of surgical technique for carotid entarterectomy (CEA) has its specific complications, compromising the final surgical result. The authors report about a 70-year old man, suffering from recurrent transient ischemic attacks by suspected internal carotid artery (ICA) re-stenosis, 11 and 13 years after CEA with patch angioplasty. In relation to neurological symptomatic and angiographic appearance of ICA re-stenosis an open surgery of the left ICA was preferred. Intraoperatively the old patch material was such vulnerable that it was not possible to maintain the continuity of ECA and ICA or CCA and ICA. Consequently reconstruction and replacement of ICA and ECA with 6 mm Gore-Tex grafts was performed. Follow-up three years after surgery showed no symptoms of insufficient brain metabolism as well as a good flow within the grafts. Patch angioplasty by CEA seems to be favourable to reduce the risk of early ICA re-stenosis but for all that there are other accompanying problems, which can compromise utility of patch technique. For this the authors prefer a patient adapted surgical treatment, based not only on so far not significant data but moreover on personal experience.

Keywords

EN

Carotid endarterectomy; patch technique; recurrent stenosis

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2007
• Volume: 2
• Issue: 3
• Pages: 335-340

Dates

published

1 - 9 - 2007

online

1 - 9 - 2007

Contributors

author

Stefan Palkovic

• Department of Neurosurgery, University of Muenster, 48129, Muenster, Germany

author

Tonny Tjan

• Cardiovascular Surgery, University of Muenster, 48129, Muenster, Germany

author

Bernhard Fischer

• Department of Neurosurgery, University of Muenster, 48129, Muenster, Germany

author

Hansdetlef Wassmann

• Department of Neurosurgery, University of Muenster, 48129, Muenster, Germany

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Identifiers

DOI

10.2478/s11536-007-0032-4