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2010, Number 1

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Rev Mex Cardiol 2010; 21 (1)

Omental transplantation on the carotid bifurcation against essential arterial hypertension

Rafael H, Ayulo V, Mego R

Language: Spanish
References: 60
Page: 19-24
PDF size: 112.33 Kb.


ABSTRACT

Introduction: Up to date it is said that the etiology of essential arterial hypertension (EAH) is unknown and is a challenge for medical community. Objective: To ameliorate the cerebrovascular sequelae of patients with EAH by means of omental transplantation. Material and methods: We present a prospective study into 81 patients with EAH who were admitted to the hospital by cerebral sequelae (62 cases), transient ischemic attacks (13 cases) and cerebellar sequelae (6 cases). Preoperative computarized tomography and/or magnetic resonance imaging showed atherosclerosis at the supraclinoid carotids and vertebrobasilar system. Through a transsylvian approach we located the supraclinoid carotids and its branches into 60 patients. During the surgery we found atherosclerosis in the carotids, some exsanguinated perforating arteries and another perforating branches with residual blood flow centripetal to the origin of these vessels. The omentum was placed on the carotid bifurcation and anterior perforated space. Results: The 81 patients presented neurological improvement since the first days of the operation. Moreover, the 60 patients who received omentum on the carotid crotch showed normalization of the neurogenic hypertension (main representative of EAH). Conclusions: These results indicate that ischemic neurons in the posterior hypothalamic nuclei are the main responsibles of neurogenic hypertension; because in contrast to this, its revascularization by means of omental tissue normalize the essential hypertension.


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