[The subclavian-carotid bypass as a method for treating obstruction of the common carotid].
Common carotid artery occlusion is a relatively uncommon lesion (0.5-5% of patients with cerebral ischaemia). Cerebral revascularization is possible only in case of patent carotid bifurcation, three patients, all of them symptomatic (2 TIA's and 1 amaurosis fugax) with a complete common carotid artery occlusion have been treated with a subclavian-carotid artery by-pass (2 PTFE, 1 reversed saphenous vein). Among the patients one death occurred in the fourth postoperative day by bronchopneumonia, no stroke was detected, in the remaining two, the by-pass was patent one year and respectively three years post-operatively. In case of common carotid artery occlusion, visualization of bifurcation is usually better obtained through a color-duplex than arteriography. Several operations have been proposed in these patients (retrograde thrombectomy, carotid to carotid by-pass, carotid-subclavian reimplantation), but subclavian to carotid by-pass is the most safe and common used procedure.
Adovasio
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R
Istituto di Patologia Speciale Chirurgica, Università degli Studi di Trieste.
Visintin
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E
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods; D006801:Humans; D008297:Male; D011859:Radiography; D012501:Saphenous Vein / Q000637:transplantation; D013348:Subclavian Artery / Q000601:surgery*; D014463:Ultrasonography
Il by-pass succlavio-carotideo quale metodica di trattamento dell'ostruzione della carotide comune.