Carotid Endarterectomy for Symptomatic Carotid Artery Disease Demonstrated by Duplex Ultrasound With Minimal Arteriographic Findings

1996 ◽  
Vol 10 (4) ◽  
pp. 385-389 ◽  
Author(s):  
Ali F. AbuRahma ◽  
John F. White ◽  
James P. Boland
2017 ◽  
Vol 51 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Carlos A. Hinojosa ◽  
Javier E. Anaya-Ayala ◽  
Hugo Laparra-Escareno ◽  
Adriana Torres-Machorro ◽  
Rene Lizola ◽  
...  

Symptomatic carotid artery atherosclerotic disease is an indication for carotid artery endarterectomy. The coexistence of carotid body tumors (CBTs) with symptomatic carotid disease is rarely encountered and adds significant challenges to vascular surgeons, with a reported overall mortality for patients who undergo endarterectomy and tumor excision of 8.8%, as opposed to the 2% for those who had CBT excision only. We describe the case of a 79-year-old female who experienced an acute cerebrovascular accident in the left hemisphere; duplex ultrasound revealed high-grade carotid stenosis in the left side and the presence of a Shamblin I CBT. The risks and benefits of the planned operation were reviewed, and the decision was made to proceed with early carotid endarterectomy and concomitant surgical resection of the tumor using the retrocarotid dissection technique. The patient recovered well, and at 11 months from the combined procedure, her neurological deficits improved significantly.


Neurology ◽  
1997 ◽  
Vol 49 (5) ◽  
pp. 1360-1364 ◽  
Author(s):  
Ulf Havelius ◽  
David Bergqvist ◽  
Bengt Hindfelt ◽  
Torsten Krakau

We have reported that dark vision is impaired in symptomatic carotid artery disease and that the impairment correlates with internal carotid artery stenosis. To find out whether this impairment is reversible after carotid endarterectomy, dark adaptation was examined pre- and postoperatively. Twenty-one consecutive patients were examined by dark adaptometry. Two examinations were done for each eye on two consecutive days pre- and postoperatively. Thirty-one matched control subjects were examined under identical conditions. The control subjects did not have clinical evidence of carotid artery disease. Patients and control subjects were free of ophthalmologic disorders. Dark vision frequently improved remarkably after endarterectomy. The average retinal sensitivity to light in darkness on the operated side doubled, and there was also improvement on the nonoperated side. There was no significant change in dark vision in the control subjects, negating a learning effect. The findings suggest the existence of reversible neuronal ischemia secondary to hemodynamic causes or frequent subclinical microembolization. Because the circulatory conditions are optimized, formerly inactive, surviving neurons may regain function.


2009 ◽  
Vol 4 (1) ◽  
pp. 98
Author(s):  
Brian G Hynes ◽  
Thomas J Kiernan ◽  
Nicholas J Ruggiero ◽  
Bryan P Yan ◽  
Michael R Jaff ◽  
...  

Stroke-related morbidity and mortality remain unacceptably high. Recent estimates suggest that it accounts for approximately one out of every 17 deaths in the US, with one death from the direct consequences of stroke every three to four minutes. Of the almost 800,000 strokes that occur annually, 87% are ischaemic, the remainder occurring predominantly as a consequence of intracerebral haemorrhage. The accessibility of the extracranial internal carotid artery to revascularisation, together with the strong correlation between the severity of carotid artery stenosis and the further risk of stroke in patients who have already experienced a transient ischaemic attack (TIA) or stroke (up to 35% at five years in one series), has driven the field of carotid endarterectomy (CEA) and carotid artery stenting (CAS). In this article we will discuss the merits and risks of both of these revascularisation methods for patients with symptomatic extracranial carotid artery disease.


Author(s):  
James Hu ◽  
◽  
Andy Sohn ◽  
Justin George ◽  
Rajesh Malik ◽  
...  

Carotid artery atherosclerotic disease impacts over 2 million Americans annually. Since the advent of the carotid endarterectomy by Debakey in 1953, the surgical management of carotid artery stenosis has prevented cerebrovascular accidents. The technology utilized to manage carotid artery stenosis continued to evolve with the utilization of carotid artery stenting in 1989 and more recently transcarotid artery revascularization (TCAR). This review discusses the modern management of carotid artery stenosis with an emphasis on transcarotid artery revascularization (TCAR) and reversal of flow for reversal of flow for embolic protection.


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