Carotid artery reconstruction and routine use of intraluminal shunt.
Complications of carotid artery reconstruction were reviewed in two groups of patients. In group A (213 patients, operation 1978-85) the surgical procedure varied according to intraoperatively measured back pressure in the internal carotid artery (ACI), with temporary intraluminal shunt when the ACI pressure was < 50 mmHg, but no shunt when the pressure was higher. In group B (339 patients, operation 1986-93), shunt was used in all cases. The incidence of complications was higher in group A than in group B (21.6% vs 13%). Temporary or permanent neurologic deficit occurred in 11.3% of the group A patients and in 5.6% of the group B patients. Routine use of temporary intraluminal shunt thus resulted in fewer complications of carotid artery surgery and allowed the surgeon to work undisturbed, a prerequisite for a successful outcome.
Grga
A
A
Centre for Vascular Diseases, Clinical Hospital Merkur, Zagreb, Croatia.
Hlevnjak
D
D
Sarlija
M
M
Morovic-Vergles
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002339:Carotid Arteries / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011336:Probability; D011379:Prognosis; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D015996:Survival Rate