Adventitial stripping for carotid sinus syndrome.
Patients with a carotid sinus syndrome (CSS) suffer from spells of dizziness and loss of conscience due to an exaggerated carotid baroreflex response. Three types of the syndrome are described: cardioinhibitory, vasodepressor and a mixed form. The gold standard for treatment is insertion of a pacemaker, but this therapy may be effective only in a pure cardioinhibitory type. In contrast, surgically interrupting afferent nerves at the origin may offer relief of symptoms in all three types. The present review analyzes the results of a surgical technique termed "adventitial stripping" of the carotid sinus. Data from 130 procedures demonstrate that carotid denervation is effective in 85% of CSS cases with low complication rates. Postoperative monitoring is mandatory as transient alterations in blood pressure and heart rate may occur.
Toorop
R J
RJ
Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands. rtoorop@yahoo.com
Scheltinga
M R M
MR
Moll
F L
FL
D017763:Autonomic Denervation / Q000009:adverse effects / Q000379:methods*; D017704:Baroreflex; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002346:Carotid Sinus / Q000294:innervation / Q000601:surgery*; D003238:Connective Tissue / Q000601:surgery*; D004244:Dizziness / Q000209:etiology; D006339:Heart Rate; D006801:Humans; D013575:Syncope / Q000209:etiology; D013577:Syndrome; D016896:Treatment Outcome