A technique for correction of carotid kinks and coils following endarterectomy |
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Authors: | Paul S. Collins MD FACS MAJ MC Paul Orecchia MD FACS Edward Gomez MD FACS MAJ MC |
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Affiliation: | (1) Department of Vascular Surgery, Letterman Army Medical Center, San Francisco, California;(2) Walter Reed Army Medical Center, Washington, District of Columbia;(3) 726 19th Avenue, 33704 NE, St. Petersburg, Florida |
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Abstract: | This study presents a technique to correct kinking or coiling of the internal carotid artery using patch angioplasty following endarterectomy, resection, and anastomoses of the vessel. Since 1984, 579 carotid endarterectomies have been performed with 19 patients (3.3%) having arteriosclerotic carotid bulb and internal carotid artery disease associated with a carotid kink or coil. These have been treated successfully using the technique of resection and patch angioplasty. The indications for surgery included seven patients with transient ischemic attacks (36.8%); seven patients who had suffered a cerebrovascular accident (36.8%); amaurosis fugax in two patients (10.5%); and one patient each with Hollenhorst plaque (5.3%), central retinal artery occlusion (5.3%), and an asymptomatic critical stenosis (5.3%). All patients had successful repair of the vessel using saphenous vein or Dacron patch angioplasty. There were no perioperative strokes or deaths. Follow-up ranged from four months to 58 months (mean 25 months). All vessels are patent with no evidence of stenosis. One patient had an ipsilateral cerebrovascular accident but had no evidence of recurrent carotid disease. Surgical correction of the carotid kink or coil can present a difficult surgical problem, and resection, fixation, or transposition can be complicated. The technique of endarterectomy, resection of the redundant vessel with anastomosis of the back wail, and patch angioplasty has been used effectively and safely in this series of patients.Presented at the Fifteenth Annual Meeting of the Peripheral Vascular Surgery Society, June 2, 1990, Los Angeles, California.The views and opinions expressed in this paper are those of the authors and do not reflect those of the Department of the Army, Department of Defense, or of the Uniformed Services University of the Health Sciences. |
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Keywords: | Carotid endarterectomy carotid kinks carotid coils extracranial atherosclerosis, See atherosclerosis atherosclerosis |
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