Revascularization of the internal carotid artery for isolated, stenotic, and symptomatic kinking.
OBJECTIVE
The operation for isolated, stenotic, and symptomatic kinking of the internal carotid artery is safe and effective in preventing stroke and relieving the symptoms of cerebral ischemia.


METHODS
A consecutive sample clinical study with a mean follow-up of 44 months.


METHODS
The surgical department of an academic tertiary care center and an affiliated secondary care center.


METHODS
Fifty-four patients with a mean age of 67 years underwent 55 revascularizations of the internal carotid artery. The surgical procedures consisted of the following: shortening and reimplantation in the common carotid artery in 36 cases, bypass grafting in 15 cases, and transposition into the external carotid artery in 4 cases.


METHODS
Cumulative survival, primary patency, and stroke-free and neurologic symptom-free rates expressed by standard life-table analysis.


RESULTS
No patients died in the postoperative period. The postoperative stroke rate was 1.8%. The cumulative rates (SEs) at 5 years were as follows: survival, 70% (10.2%); primary patency, 89% (7.8%); overall stroke free, 92% (6.8%); ipsilateral stroke free, 96% (5.3%); neurologic symptom free, 90% (7.5%); and ipsilateral symptom free, 93% (6.5%).


CONCLUSIONS
Revascularization of the internal carotid artery for the treatment of isolated, stenotic, and symptomatic kinking is safe and effective in preventing stroke and relieving symptoms of cerebrovascular insufficiency.
Illuminati
Giulio
G
Francesco Durante, Department of Surgical Sciences and Applied Technology, University of Rome La Sapienza, Via Vincenzo Bellini 14, 00198 Roma, Italy. giulio.illuminati@uniroma1.it
Calió
Francesco G
FG
Papaspyropoulos
Vassilios
V
Montesano
Giuseppe
G
D'Urso
Antonio
A
D000368:Aged; D002545:Brain Ischemia / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D020521:Stroke / Q000517:prevention & control; D014654:Vascular Patency