Flores-Izar FJ, Baeza-Galván BI, Bizueto-Rosas H, Hugo Alonso Pérez-González HA, Gómez-Calvo CD, Hernández-Pérez NA

Language: Spanish
References: 13
Page: 70-76
PDF size: 269.20 Kb.

ABSTRACT

Background. Atherosclerotic carotid disease and vessel elongation increase its frequency among older patients. Female sex, smoking, hypertension, dyslipidemia, diabetes mellitus 2, clamping time, miointimal hyperplasia, number and type of anastomosis are considered risk factors for carotid restenosis.
Objective. To simplify the surgical management of atheroslcerotic carotid disease.
Material and methods. Twenty-two patients were included from March 2012 to February 2015, all of them underwent surgery for carotid disease with elongated vessel; 17 men and 5 women, with an average age of 73 years. Patients had arterial hypertension in 90%, smokers 45%, dyslipidemic 68%, and diabetics 36%. We reviewed the clinical records in search of complications during and after the surgery; clamping time, haematoma, infection, and restenosis.
Results. Twenty unilateral carotid endarterectomies with resection of the elongation of the internal carotid artery in 22 patients and in 3 patients with resection of the common carotid artery elongation; carotid stenosis were between 65-90% and six patients withouth significant stenosis but with brain hypoperfusion. In one patient was required to rebuild the previous internal carotid anastomosis because residual stenosis of 50 %, describing a narrow angle between both carotid arteries internal and external, requiring a clamping time of 22 min. The follow-up showed that patients didn’t have complications in the early stage and in the follow-up continued without data failure syndrome of baroreceptor.
Conclusion. The candidates for carotid endarterectomy should be integrally evaluated, identifying the treatment according to risk factors in order to optimize the results, reducing the morbidity and mortality and improving their post-surgical prognosis. A minor time of clamping, eliminate areas that may generate embolism or thrombosis, a simple and unique anastomosis all meet the basic principles for the standards of vascular anastomoses.

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