Intraluminal shunt during carotid endarterectomy

Abstract


Clamping of internal carotid artery (ICA) in conditions of insufficient collateral circulation leads to the cerebral hypoperfusion. In 20% of cases, postoperative stroke can be caused by hemodynamic insufficiency. We analyse our experience of temporary shunting (TS) aimed to maintain cerebral perfusion during the vascular clamping. From January 2009 to May 2011, the Pruitt-Inahara TS was used during carotid surgery at 40 patients. Cases of acute cerebral ischemic events (ACIE) were not registered in the postoperative period and during follow-up. The facial neuropathy, which regressed 2-4 weeks postoperatively, was observed at 3 patients being caused by tissue traction during the dissection of «high» bifurcation of ICA. There v/ere not septic complications. Transcranial Doppler (TCD) and other methods of monitoring are appropriate for assessment of TS function.

A Vladimirovich Zholkovskiy

South Region Medical Center of Federal Medical Biological Agency, Rostov-on-Don

Email: alexangio@newmail.ru

V V Ermolenko

South Region Medical Center of Federal Medical Biological Agency, Rostov-on-Don

B S Abuazab

Petrozavodsk State University

N P Zhukova

South Region Medical Center of Federal Medical Biological Agency, Rostov-on-Don

E S Koblov

Mariinsky Hospital, St. Petersburg

I P Dudanov

Mariinsky Hospital, St. Petersburg

  1. Покровский A.B. Может ли кардиолог спасти больного от инсульта? // Кардиология. 2003. № 3. С. 4-6.
  2. Krul J.M.J., van Gyn J., Ackerstaff R.G.A. et al. Site and pathogenesis of infarcts associated with carotid endarterectomy // Stroke. 1989. Vol. 20. P. 324-328.
  3. Thompson J.E., Austin D.J., Patman R.D. Carotid endarterectomy for cerebrovascular insuffi-ciency:long-term results in 592 patients followed up to 13 years // Ann. of Surgery. 1970. Vol. 172. P. 663-679.
  4. Green R.M., Messick W.J., Ricotta J.J. et al. Benefits, shortcomings and costs of EEC monitoring // Ann. of Surgery. 1985. Vol. 201. P. 785-792.
  5. Halsey J.H. Risks and benefits of shunting in carotid endarterectomy // Stroke. 1992. Vol. 23. P. 1583- 1587.
  6. Ouriel K., Green R.M. Clinical and technical factors influencing recurrent carotid stenosis and occlusion after endarterectomy // J. of Vase. Surg. 1987. Vol. 5. P. 702-706.
  7. Sundt T.M. The ischemic tolerance of neural tissue and the need for monitoring and selective shunting during carotid endarterectomy // Stroke. 1983. Vol. 14. P. 93-98.
  8. Counsell C., Salinas R., Naylor R., Warlow C. Routine or selective carotid artery shunting during carotid endarterectomy and the different methods of monitoring in selective shunting // Stroke Module of the Cochrane Database of Systematic Reviews (updated 01.12.97) // Warlow C., Van Gijn J., Sandercock P., Candelise L., Langhorne P. (eds.). Available in the Cochrane Library (database on disk and CD-ROM). The Cochrane Collaboration; issue 1. Oxford: Update Software; 1998. Updated quarterly.
  9. Цеханович В.H., Губенко A.A., Лоенко В.Б. и др. Защита головного мозга при каротидной эндартерэктомии у больных с окклюзирующим атеросклерозом сонных артерий // Бюл. НЦССХ им. А.Н. Бакулева РАМН «Сердечно-сосудистые заболевания». 2007. Т. 8. № 6 (приложение). С. 142.
  10. Гавриленко A.B., Куклин A.B., Скрылев С.И., Агафонов И.Н. Показания для использования внутрипросветного временного шунта при операциях на сонных артериях // Ангиология и сосудистая хирургия. 2007. Т. 13. №4.
  11. Aukland A., Hurlow В.A. Carotid restenosis due to clamp injury// Br. Med. J. 1981. Vol. 282. P. 2013.
  12. Дуданов И.П., Субботина H.C., Стафеева И.В. Характеристика и прогностическое значение показателей внутриполушарной когерентности в остром периоде ишемического инсульта: Материалы всероссийской юбилейной научно-практической конференции «Актуальные проблемы клинической неврологии», 20-30 сентября 2009 г. СПб МАПО. Санкт-Петербург, 2009. С. 119.
  13. Абу Азаб Б.С., Гавриленко A.B., Дуданов И.П. Сравнительная характеристика методов эндартерэктомии при атеросклеротическом поражении сонных артерий // Мед. акад. журн. 2005. № 2. Т. 5. Прил. 6. С. 247-249.

Views

Abstract - 22

Cited-By


PlumX

Refbacks

  • There are currently no refbacks.

Copyright (c) 2011 Zholkovskiy A.V., Ermolenko V.V., Abuazab B.S., Zhukova N.P., Koblov E.S., Dudanov I.P.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies