Document Detail


Significant differences in the postoperative morphological and hemodynamic conditions of carotid arteries of patients undergoing stenting or endarterectomy with patch angioplasty.
MedLine Citation:
PMID:  19834400     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Carotid endarterectomy with a patch graft (Patch CEA) has been our standard treatment for patients with carotid artery stenosis, but carotid artery stenting (CAS) has emerged as an alternative. The purpose of this study was to compare the postoperative changes in the configurations and the flow velocities of carotid arteries after CAS or Patch CEA. METHODS: Thirty-one patients undergoing CAS or Patch CEA were included. The pre- and postoperative shapes of the carotid arteries were evaluated by angiography and ultrasonography. Doppler waveforms were recorded in the middle portion of the common carotid artery and in the internal carotid artery bulb to measure flow velocities, including peak systolic, mean, and end-diastolic velocities. RESULTS: Eighteen patients were treated by CAS, and Patch CEA was performed for 13 patients. Preoperatively, there were no differences in the degrees of stenosis or the flow velocities between the 2 groups. The averages of the diameters of the postoperative internal carotid artery bulbs were 4.5 mm in the CAS group and 7.0 mm in the Patch CEA group (P < 0.01). The averages of peak systolic, mean, and end-diastolic velocities measured in the internal carotid artery were 80, 42, and 25 cm/s, respectively, in the CAS group, and were significantly greater than those (53, 28, and 16 cm/s, respectively) in the Patch CEA group (P < 0.01). CONCLUSION: Significant differences in postoperative morphological and hemodynamic conditions between CAS and Patch CEA were observed. The impact of these differences will be determined by further studies.
Authors:
Koji Tokunaga; Kenji Sugiu; Hitoshi Hayase; Ayumi Nishida; Isao Date
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  65     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-16     Completed Date:  2009-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  884-8; discussion 888-9     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. kojitoku@md.okayama-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography
Angioplasty*
Carotid Artery, Internal / radiography*,  ultrasonography*
Carotid Stenosis / surgery*
Endarterectomy, Carotid*
Female
Hemodynamics
Humans
Male
Middle Aged
Postoperative Period
Stents*
Treatment Outcome
Ultrasonography, Doppler, Duplex

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


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