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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 2000 September;7(3):233-9

language: English, Italian

Urgent carotid surgery. Presentation of a case of acute stroke caused by cardiac embolism

Ronsisvalle S., Pettenuzzo F., Vedolin G. *, Caporale F. **, Faresin F. **

From the Department of Vascular Surgery * Anaesthesia and Resuscitation ** Geriatrics Cittadella Hospital, ASL n. 15, Cittadella (Padua)


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Between January 1997 and September 1998, 406 carot­id endar­te­rec­to­mies ­were per­formed ­after colour Doppler ­scans and angio­graph­ic exam­ina­tions of the supraor­tic trun­ci. Since September 1998, 100 of the 150 sur­gi­cal pro­ce­dures ­were per­formed ­after colour Doppler ­scans ­alone. For the ­past ­year all ­patients suf­fer­ing ­from ­acute cereb­ro­vas­cu­lar inci­dents ­have ­been includ­ed in a diag­nos­tic-ther­a­peu­tic pro­to­col for ­urgent/emer­gen­cy cas­es of carot­id sur­gery ­based on the assump­tion ­that sur­gery ­will be per­formed ­with a max­i­mum 6 ­hours of ­onset, ­that the cere­bral CT ­scan is neg­a­tive or ­reveals ­only ­minor ischaem­ic dam­age, ­that a colour Doppler ­scan is per­formed ­with angio­graph­ic exam­ina­tion of sur­gi­cal­ly treat­able carot­id ­lesions (pro­nounced sten­o­sis, pseu­do-occlu­sion, seg­men­tary occlu­sion, dis­sec­tion) as an option­al ­extra. The ­paper ­describes the man­age­ment of one ­case of ­acute ­stroke ­caused by a car­diac embo­lism. Though numer­i­cal­ly lim­it­ed the ­results sup­port ­data report­ed in the lit­er­a­ture in sug­gest­ing ­that sur­gi­cal treat­ment of the ­type of carot­id ­lesions ­described can ­resolve ­major neu­ro­log­i­cal pic­tures and ­that the colour Doppler ­scan ­offers sig­nif­i­cant infor­ma­tion on its own for the selec­tion of ­patients eli­gible for carot­id revas­cu­lar­isa­tion.

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