Journal «Angiology and Vascular Surgery» • 

2009 • VOLUME 15 • №2

MINI-APPROACH IN SURGERY OF CAROTID ARTERIES

Ignatiev I.M., Zanochkin A.V., Bredikhin R.A.
Department of Vascular Surgery Federal Facility Interregional Clinical and Diagnostic Centre
Kazan, Russia

The purpose of this study was to assess the outcomes of using a mini-approach in surgery of carotid arteries. From September 2006 to December 2007, one hundred and twenty-nine patients (with a total of 139 operations sustained) underwent interventions on the carotid bifurcation for atherosclerotic lesions and pathological tortuosity of the carotid arteries. The patients were subdivided into two groups. Group A consisted of those operated on from the standard access to the carotid arteries, with Group B comprising the patients undergoing interventions on the carotid bifurcation from a mini-approach (a cutaneous incision less than 5 cm long, averaging 4.7±0.3 cm). The control Group C was composed of forty-two patients having endured operations on the carotid arteries from the conventional access performed at other specialised departments.

In the patient groups referred to above, we compared the incidence rate of perioperative complications (stroke/death), lesions of the cranial and cervical nerves, as well as wound complications. In Group A patients, there were two patients with stroke, one of whom had eventually died. Neuropathies of the cranial and cervical nerves in this group of patients were observed to have developed in eight (6.2%) and ninety-two (71.3%) cases, respectively, and in Group C patients – in eleven (28.0%) cases. Cervical haematoma was observed in fourteen (10.9%) subjects. The average duration of the postoperative hospital stay amounted to 6.8±1.1 days. Amongst the Group B patients, cervical haematoma was noted in two (3.2%, P<0.0001) cases only. A lesion of the cranial nerves (that of the superior laryngeal nerve) took place in two patients (P<0.0001), and that of the cervical nerves – in four patients (P<0.0001). No cheloid cicatrices were observed. The patients reported excellent and aesthetically pleasing surgical outcomes. The average duration of the postoperative hospital stay amounted to 2.8±0.69 days (P=0.002).

Hence, operations on the carotid bifurcation may be successfully performed from a mini-approach, with thus discomfort kept at a minimum and rapid rehabilitation of patients.

KEY WORDS: mini-approach, carotid bifurcation, carotid endarterectomy, lesions of the cranial and cervical nerves, wound complications.

P. 99-102

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