title: "Extarterectomy" for tumors invading the carotid artery: an animal model.
abstract: OBJECTIVE
  Carotid artery (CA) invasion by head and neck tumors is a challenging problem for the cranial base surgeon. Proposed methods for management have the disadvantage of constant or temporary interruption of the arterial blood flow and, as a consequence, cerebral ischemic complications. The objective of the study was to investigate the long-term effects of a novel technique, "extarterectomy," on the vascular wall and the arterial blood flow in an ovine model.
  
  
  METHODS
  Wallstents were implanted bilaterally in the common CA of 5 sheep by the Seldinger technique. Six weeks after stent implantation, a segment of the arterial wall of about 2 cm in length was peeled off the external surface of the stent. Six months later, control angiography was performed. The animals were sacrificed after 18 months and the "extarterectomized" arteries were removed for the microscopic and macroscopic evaluation.
  
  
  RESULTS
  There were no acquired neurological deficits in the study group. Extarterectomy was performed without any complication in every case. Control angiography confirmed patent CAs. Evaluation by light microscopy showed the "neointimal" layer within the interstices of the stent.
  
  
  CONCLUSIONS
  Extarterectomy allows aggressive tumor removal together with the maintenance of blood flow through the CA and offers hope for those with tumors invading the CA.
authors.affiliation: Department of Neurosurgery, Ege University, School of Medicine, Izmir, Turkey.
authors.forename: Kazım
authors.initials: K
authors.lastname: Oner
authors.forename: Cem
authors.initials: C
authors.lastname: Bilgen
authors.forename: Ismail
authors.initials: I
authors.lastname: Oran
authors.forename: Tayfun
authors.initials: T
authors.lastname: Kirazli
authors.forename: Ahmet
authors.initials: A
authors.lastname: Memiş
authors.forename: Izzet
authors.initials: I
authors.lastname: Ovül
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yilmaz