Polytetrafluoroethylene bypass for revascularization of the atherosclerotic internal carotid artery: late results.
Between 1979 and 1986, 60 patients underwent a total of 62 revascularizations of the internal carotid artery with an expanded polytetrafluoroethylene (ePTFE) bypass. In 54 cases, the indication for surgery was the presence of extensive lesions in both the internal and common carotid arteries and, in 8 cases, a late complication of a previous surgical procedure. There were no early postoperative deaths (within 30 days). Three patients (5%) experienced postoperative neurologic complications. Two complications resolved completely whereas one left minimal residua. The bypasses remained patent in all three cases. All patients had early postoperative Doppler B-mode ultrasonography. Two early occlusions (3.2%) were disclosed but the patients remained symptom-free. Four neurologic complications were observed over long-term (average 23 months) follow-up. None were related to the operated carotid artery. There were no cases of infection or late occlusion. No hemodynamic or morphologic anomalies were observed on late follow-up ultrasound studies. These favorable results support the use of ePTFE as a reliable substitute when adequate autologous saphenous vein is not available for carotid bypass. Routine utilization might be indicated in cases of long bypasses, especially when it is necessary to implant the bypass on the ascending aorta, or when the proximal site of implantation is made on a thickened arterial wall.
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011859:Radiography; D012189:Retrospective Studies; D014654:Vascular Patency
D011138:Polytetrafluoroethylene