scholarly journals External Carotid Artery Shunting During Carotid Endarterectomy: An Alternative for Cerebral Protection?

2001 ◽  
Vol 22 (4) ◽  
pp. 306-309 ◽  
Author(s):  
P. Belardi ◽  
C. Finocchi ◽  
G. Lucertini ◽  
A. Viacava ◽  
G. Simoni
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
External Carotid Artery ◽  
Cerebral Protection ◽  
External Carotid

Differential Effects of Carotid Artery Stenting Versus Carotid Endarterectomy on External Carotid Artery Patency

2007 ◽  
Vol 14 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Edward Y. Woo ◽  
Jagajan Karmacharya ◽  
Omaida C. Velazquez ◽  
Jeffrey P. Carpenter ◽  
Christopher L. Skelly ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenting ◽  
External Carotid Artery ◽  
External Carotid ◽  
Differential Effects

Cerebral Protection with a Temporary Ascending Aorta–External Carotid Artery Bypass during Common Carotid Artery Revascularization

2018 ◽  
Vol 46 ◽  
pp. 368.e13-368.e17
Author(s):  
Murat Ugurlucan ◽  
Yilmaz Onal ◽  
Didem Melis Oztas ◽  
Cagla Canbay ◽  
Ibrahim Demir ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Artery Bypass ◽  
External Carotid Artery ◽  
Ascending Aorta ◽  
Cerebral Protection ◽  
External Carotid

Cerebral Protection With a Crossover External Carotid Artery Bypass During Arch Debranching

2015 ◽  
Vol 99 (2) ◽  
pp. 725-727 ◽  
Author(s):  
Murat Ugurlucan ◽  
Omer Ali Sayin ◽  
Mehmet Akif Onalan ◽  
Nijat Alishev ◽  
Murat Basaran ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Artery Bypass ◽  
External Carotid Artery ◽  
Cerebral Protection ◽  
External Carotid

In Vitro Comparison of Four Cerebral Protection Filters for Preventing Human Plaque Embolization during Carotid Interventions

2002 ◽  
Vol 9 (6) ◽  
pp. 793-802 ◽  
Author(s):  
Stefan Müller-Hülsbeck ◽  
Thomas Jahnke ◽  
Carsten Liess ◽  
Christoph Glass ◽  
Friedrich Paulsen ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
Cerebral Protection ◽  
External Carotid ◽  
Carotid Angioplasty ◽  
Protection Device ◽  
Fluid Medium ◽  
Vitro Model

Purpose: To evaluate in an in vitro bench-top model the efficacy of 4 filtration devices designed for cerebral protection during carotid angioplasty. Methods: Embolization during carotid angioplasty was simulated with human plaque material (8 to 12 particles weighing 6.02 ± 0.10 mg) in an open flow model with the aortic arch and carotid bifurcation made from elastic silicone tubes and saline used as the fluid medium. The 500 to 1500-µm particles were injected into the internal carotid artery (ICA) in front of the test protection device, which was deployed 5 cm distal to the bifurcation. Particles getting past the protection device or flowing into the external carotid artery (ECA) were caught in 100-µm filters and weighed. Ten trials were made on each of 4 devices: Angioguard, FilterWire EX, TRAP, and NeuroShield. All were deployed according to the manufacturers' directions except the FilterWire, which was manually repositioned in all tests to eliminate a gap between the filter and the tube wall. Results: The lowest weight of missed particles in the effluent was obtained with the NeuroShield (0.05 ± 0.04 mg, 0.8% of injected particle weight) and FilterWire (0.08 ± 0.05 mg, 1.3%; p=0.254 compared to NeuroShield, p=0.006 versus TRAP). The weight of particles missed by the TRAP device (0.16 ± 0.06 mg, 2.6%; p<0.001 versus NeuroShield and Angioguard, p<0.05 compared to Filter Wire) was higher, and the largest amount of missed particles was observed with the Angioguard filter (0.27 ± 0.06 mg, 4.4%; p<0.001 compared to all). NeuroShield and FilterWire were significantly different (p<0.001) compared to Angioguard and TRAP in a pairwise analysis. No embolization into the ECA occurred. Conclusions: In vitro, none of the tested devices had the ability to completely prevent embolization into the ICA. Comparing current designs, the NeuroShield filter and the FilterWire EX captured the highest percentage of human particles in this in vitro model, probably due to their larger filter volume.

scholarly journals Analysis of twisted internal carotid arteries in carotid endarterectomy

2020 ◽  
Vol 11 ◽  
pp. 147
Author(s):  
Masaru Honda ◽  
Hajime Maeda
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Preoperative Evaluation ◽  
Twist Angle ◽  
Head Rotation ◽  
Skin Incision ◽  
External Carotid Artery ◽  
External Carotid ◽  
Position Correction

Background: The twisted carotid artery is a variant, in which the internal carotid artery (ICA) courses medially to the external carotid artery. Due to the sparse descriptions in the literature, we, here, report our experience with cases of carotid endarterectomy (CEA) for twisted carotid artery and its clinical features. Methods: Fifty-seven consecutive CEA-treated patients were evaluated, and the twist angle was measured on the source images of axial slices of computed tomography angiography (CTA). Results: Eight male patients (14.2%) demonstrated a twisted right ICA (mean age, 77.0 ± 2.6 years; and mean stenosis, 66.9% ± 19.9%). The mean twist angle was 30.1° ± 17.9°, while the normal ICA is angled at −23.0° ± 12.3°. No statistical differences in the distribution of coexisting diseases were found between the normal and twisted ICA cases. CEA was successfully performed with the correction of the carotid position in all cases; however, significant position correction was not observed in the postoperative evaluation. Right-side dominancy (P = 0.045) and prolonged clamping time (P = 0.053) were observed in the twisted cases. Conclusion: Twisted ICA was preferentially found in the right ICA and men. CEA of the twisted ICA was safely performed with appropriate head rotation and wider longitudinal skin incision than usual without a significant increase in the operative time. CTA is useful for preoperative evaluation. This specific variation should be considered by the neurosurgeon involved in the evaluation and treatment of carotid stenoses.

Revisiting carotid endarterectomy: Neobulb technique using external carotid artery as a patch

Vascular ◽  
2021 ◽  
pp. 170853812110523
Author(s):  
Adalberto P Araujo ◽  
Cristiane F Araujo‐Gomes ◽  
Douglas Poschinger-Figueiredo ◽  
Carlos Felipe S Delgado ◽  
Monica R Mayall ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
Long Term Follow Up ◽  
Distal Flow

Objectives This study describes an alternative carotid bifurcation endarterectomy technique in which the external carotid artery is used as a suture patch. Methods Charts of ten patients with atherosclerotic carotid stenosis that were treated using the neobulb technique between 2002 and 2019 were reviewed. Results No major surgical adverse event was observed in the postoperative assessments. No postoperative common or internal carotid stenosis was observed in the mid- or long-term follow-up. Conclusions The neobulb technique allows carotid endarterectomy closure without a synthetic or venous patch, using the external carotid artery as an autologous patch, while preserving distal flow into the external carotid artery branches.

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