title: Intraoperative innominate and common carotid intervention combined with carotid endarterectomy: a "true" endovascular surgical approach.
abstract: OBJECTIVE
  To report the technique of carotid endarterectomy (CEA) combined with retrograde balloon angioplasty and stenting of proximal "tandem" lesions in the supra-aortic trunk.
  
  
  METHODS
  Intraoperative techniques in 34 patients with 23 left common carotid artery (CCA) and 11 innominate artery lesions included general anesthesia, low-dose dextran, prosthetic patching, selective shunting, 8-F sheath entry into the native CCA before the CEA, manual CCA sizing, and balloon-expandable stent placement after predilation. The technique has a high procedural success rate (97%) and appears durable. Over a mean 34-month follow-up, 2 >70% ostial CCA restenoses were found at 24 months.
  
  
  CONCLUSIONS
  Intraoperative innominate or left CCA balloon angioplasty/stenting combined with carotid endarterectomy is safe, effective, and durable.
authors.affiliation: Cardiovascular Institute of the South, Southwest Medical Center, Lafayette, Louisiana, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Allie
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Hebert
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Lirtzman
authors.forename: Charles H
authors.initials: CH
authors.lastname: Wyatt
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Khan
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Khan
authors.forename: Peter S
authors.initials: PS
authors.lastname: Fail
authors.forename: Gary A
authors.initials: GA
authors.lastname: Chaisson
authors.forename: V Antoine
authors.initials: VA
authors.lastname: Keller
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Vitrella
authors.forename: Sonja D
authors.initials: SD
authors.lastname: Allie
authors.forename: Adam A
authors.initials: AA
authors.lastname: Allie
authors.forename: Elena V
authors.initials: EV
authors.lastname: Mitran
authors.forename: Craig M
authors.initials: CM
authors.lastname: Walker
mesh_terms: D000792:Angiography; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003131:Combined Modality Therapy; D016894:Endarterectomy, Carotid / Q000295:instrumentation*; D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome