Although carotid endarterectomy is the standard procedure, the purpose of this paper is to describe a new surgical technique and indicate its role in the surgery of cervical @entity66 . The technique consists of resection of the pathologic carotid artery bifurcation followed by its total replacement with a bifurcated thin-wall @entity736 ( @entity736 ) graft constructed by the surgeon. Prosthetic graft reconstruction of the carotid bifurcation (PGRCB) was performed in 21 @entity1 (25 procedures) from November 1984 to May 1987. Many @entity1 were over 70 years old. The indications for surgery were @entity63 ( @entity63 )'s in 10 @entity1 (high-grade @entity850 ), @entity64 with mild deficit in 3 @entity1 (high-grade @entity850 ). Eight @entity1 (high-grade @entity850 ) were asymptomatic and 4 had vertebro-basilar symptoms. In 11 procedures the indications were the same as for standard carotid endarterectomy (significant @entity850 and/or ulcerated plaque). In 14 cases, the procedure was justified by extensive lesions involving a long segment of the internal carotid artery (2 restenoses, 12 @entity75 ). In the perioperative period, there were no deaths and no @entity63 's. The 25 procedures were assessed one month postoperatively by ultrasonic imaging and venous substraction angiography. All the grafts were patent with perfect restoration of the carotid bifurcation anatomy. Systematic follow-up study was carried out in 1987. Three @entity1 had died of non-neurologic causes and one was lost to study. The remaining 19 procedures were evaluated with an average follow-up of 19 months (range 7 to 32 months). The @entity1 were asymptomatic and all the grafts remained patent including one @entity850 (greater than 50%) at the common carotid artery @entity254 . Because recent studies have documented a much higher rate of @entity154 or recurrent @entity850 after carotid endarterectomy, we believe that PGRCB merits consideration, particularly in difficult endarterectomies, and in recurrent @entity543 . Furthermore it seems acceptable to advocate PGRCB in @entity3538 and in post-irradiation @entity3468 .

Resection and reconstruction of the carotid bifurcation with XXXX grafts; operative technique. Preliminary results in 25 procedures and indications.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity154 :: ('MESH:D000013', 'Disease') :: ['technical defects'] @entity64 :: ('MESH:D020521', 'Disease') :: ['established stroke'] @entity66 :: ('MESH:D004194', 'Disease') :: ['cerebrovascular disease'] @entity63 :: ('MESH:D007511', 'Disease') :: ['transient ischemic attacks', 'TIA'] @entity75 :: ('MESH:D001927', 'Disease') :: ['calcified lesions'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity3538 :: ('MESH:D002341', 'Disease') :: ['aneurysms of the internal carotid artery'] @entity3468 :: ('MESH:D001167', 'Disease') :: ['arteritis'] @entity736 :: ('CHEBI:53251', 'Chemical') :: ['PTFE', 'polytetrafluoroethylene'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity543 :: ('MESH:D016893', 'Disease') :: ['carotid stenosis']
@entity736 :: (CHEBI:53251,Chemical) :: ['polytetrafluoroethylene']
