Journal «Angiology and Vascular Surgery» • 

1998 • VOLUME 4 • №2

RECONSTRUCTIONS OF THE OCCLUDED COMMON CAROTID ARTERY

Gy. Sepam, M.D., A. Nemes, M.D., Cs. Dzinich, M.D., K. Huttl, M.D., M. Szazados, M.D., G. Keresztury, M.D.
Department of cardiovascular surgery Semmelweis Medical University,
Budapest, Hungary

Reports on reconstructive procedure of the common carotid artery (CCA) are relatively rare. In a 10 year period (from 1984 to 1995) we have observed 52 patients with CCA occlusion meanwhile there have been 2300 interventions performed on the internal carotid artery (ICA). Fourty six of the 52 patients underwent surgical repair. In six patients no surgical intervention was undertaken because of a complementary ICA occlusion, or complete lack of symptoms. The surgery was undertaken under general anesthesia. We have performed retrograde TEA, subclavian-carotid bypass, carotid subclavian transposition, intercaroti crossover bypass, subclavian to ICA by pass, subclavian to EAC bypass, aorta to ICA bypass, innominate to carotid bypass, innominate bicarotid bypass. In 10 patients a contralateral endarterectomy of the ICA had to be performed. There was only one death after innominate bicarotid bypass following acute brain edema in case of four vessel occlusion caused by Takayasu disease. An other patient died within 30 days postoperatively after discharge on acute M.I.Three reocclusions after prosthetic bypass procedures could be observed, 2 of them underwent successful reoperation. This experience shows that reconstruction of the occluded CCA is a safe procedure. Althouhg in patients without neurological symptoms surgery should not be obligatorily indicated.

P. 95-101

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