Document Detail

External carotid revascularization: review of a ten-year experience.
MedLine Citation:
PMID:  4032609     Owner:  NLM     Status:  MEDLINE    
In the presence of ipsilateral internal carotid artery (ICA) occlusion, external carotid artery (ECA) revascularization can improve cerebral perfusion or eliminate an embolic source. From 1974 through 1984, 37 patients at The Cleveland Clinic underwent 42 ECA reconstructions; autologous patch angioplasty and intraluminal shunting were used when feasible. Thirty procedures were limited to primary ECA revascularization, whereas 12 extended procedures were performed as reoperations after previous ECA endarterectomy or required complementary subclavian or intracranial bypass. There were no early postoperative deaths nor neurologic morbidity in the limited group, but one death, four ipsilateral hemispheric strokes, and one retinal embolism occurred in the extended group. Ten patients have died during a follow-up interval of 1 to 72 months (mean 27 months). Five late deaths were caused by myocardial infarction, only one of which was complicated by a contralateral stroke. Two additional strokes have occurred; one involved the ipsilateral and one the contralateral cerebral hemisphere. Five other patients experienced recurrent cerebral or ocular ischemic symptoms. In conclusion, extended ECA reconstruction is associated with a higher operative risk than limited revascularization. Late follow-up is necessary to detect those patients who may eventually require additional management of recurrent cerebrovascular symptoms or incidental coronary artery disease.
P J O'Hara; N R Hertzer; E G Beven
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  2     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1985 Sep 
Date Detail:
Created Date:  1985-10-02     Completed Date:  1985-10-02     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  709-14     Citation Subset:  IM    
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MeSH Terms
Arterial Occlusive Diseases / surgery*
Carotid Artery Diseases / surgery*
Carotid Artery, External / surgery*
Carotid Artery, Internal
Cerebral Revascularization*
Cerebrovascular Disorders / etiology
Follow-Up Studies
Middle Aged
Postoperative Complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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