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CURRENT ISSUEITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus

Frequency: Quarterly

ISSN 1824-4777

Online ISSN 1827-1847

 

Giornale Italiano di Chirurgia Vascolare 1998 September;5(3):151-7

    ORIGINAL ARTICLES

Surgical cor­rec­tion of tor­tu­os­ities and symp­to­mat­ic kink­ing of the inter­nal carot­id ­artery ­using a replan­ta­tion tech­nique. Personal expe­ri­ence

Angelini R., Marinucci R., Di Nardo E., Santarelli M., Ucchino S., Spigonardo F.

From the Vascular Surgery Operating Unit AUSL Chieti, Italy

Background. The ­authors ­report ­their expe­ri­ence of inter­nal carot­id ­artery (ICA) replan­ta­tion.
Methods. Between 1990 and 1997 a ­total of 412 ­patients under­went carot­id sur­gery. In 33 cas­es carot­id sur­gery was asso­ciat­ed ­with ­another oper­a­tion. In ­this ­series 42 ­patients (11.9%) under­went ICA replan­ta­tion. 14 ­patients ­revealed symp­to­mat­ic kink­ing, 9 of ­which ­were oper­at­ed bilat­er­al­ly; 19 pre­sent­ed ­marked tor­tu­os­ity of the ICA asso­ciat­ed ­with hemo­dy­nam­i­cal­ly sig­nif­i­cant and/or symp­to­mat­ic sten­o­sis affect­ing the ­same ­artery. The aim of ­this ­study was to illus­trate the replan­ta­tion tech­nique ­used and the medi­um-­term ­results (fol­low-up of 1-65 ­months, ­mean fol­low-up 35.5 ­months). The ­scope of sur­gery was to elim­i­nate the elon­ga­tion caus­ing the under­ly­ing dys­mor­phia, as ­well as treat­ing any asso­ciat­ed ­lesions. The tech­nique ­used can be divid­ed ­into two ­basic stag­es:
— expo­sure and free­ing of dys­mor­phia;
— trans­verse resec­tion of ACI, ever­sion TEA, lon­gi­tu­di­nal arte­riec­to­my of the com­mon carot­id ­artery, TEA of the lat­ter, end-to-end anas­tom­o­sis of the ICA and com­mon carot­id ­artery. A ­total of 35 ­patients (83.3%) ­were fol­lowed up.
Results. Three ­patients ­died (7%). One ­patient ­died 4 ­months lat­er for rea­sons direct­ly ­linked to sur­gery, due to the con­se­quenc­es of cere­bral hem­or­rhage ­which ­occurred ­eight ­hours ­after the oper­a­tion (2.38%); two ­died ­from oth­er caus­es (AMI in ­both cas­es ­after 24 and 30 ­months of fol­low-up) (4.76%). The remain­ing 32 ­patients ­were con­trolled as out­pa­tients and under­went ­colour Doppler sonog­ra­phy (32 out of 32) and angio­gra­phy (18 ­patients, 42.8%).
Conclusions. Good paten­cy was ­observed in all replan­ta­tions ­with no resid­u­al func­tion­al def­i­cits.

language: English, Italian


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