title: Carotid bypass with polytetrafluoroethylene grafts: a study of 110 consecutive patients.
abstract: BACKGROUND
  Carotid endarterectomy (CEA) is the standard treatment for atherosclerotic lesions involving the carotid bifurcation. However, CEA can be challenging under some conditions. We describe the technique and outcome of prosthetic carotid bypass grafting (PCB) with polytetrafluoroethylene (PTFE) grafts as an elective alternative to CEA.
  
  
  METHODS
  This retrospective analysis of prospectively collected data came from a series of 110 consecutive PCBs, that is, 9.6% of 1140 carotid revascularization procedures performed in our department between September 1986 and July 2002. Primary indications for PCB were extensive atherosclerotic lesions (n = 45, 40.9%), carotid stenosis associated with kinking (n = 29, 26.4%), recurrent stenosis (n = 18, 16.4%), and stenosis after radiation therapy (n = 7, 6.4%).
  
  
  RESULTS
  The combined stroke and death rate at 30 days was 0.9%. Mean duration of follow-up was 647 +/- 71 days. Four carotid bypass grafts (3.6%) became occluded, and stenosis recurred in 1 (0.9%). At 3 years, overall actuarial survival was 81.4 +/- 11.5 and actuarial stroke-free rate was 97.7 +/- 2.3. There were no fatal strokes.
  
  
  CONCLUSIONS
  PCB is a viable technique for treatment of extensive atherosclerotic carotid lesions, recurrent carotid stenosis, and carotid stenosis after radiation therapy. Postoperative stroke, occlusion, and recurrent stenosis rates are comparable to those associated with CEA performed under optimal conditions.
authors: Vascular Surgery Department, Jean Bernard University Hospital, Poitiers, France.
authors: Christophe
authors: C
authors: Camiade
authors: Amer
authors: A
authors: Maher
authors: Jean-Baptiste
authors: JB
authors: Ricco
authors: Jérôme
authors: J
authors: Roumy
authors: Guillaume
authors: G
authors: Febrer
authors: Christophe
authors: C
authors: Marchand
authors: Jean-Philippe
authors: JP
authors: Neau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D016893:Carotid Stenosis / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene