Carotid Artery Resection Research Articles

Ophthalmoplethysmography in head and neck surgery.

Ophthalmoplethysmography (OPG) is a simple, noninvasive diagnostic test in which the cerebral hemispheric blood flow can be indirectly measured. Its use in head and neck surgery is invaluable because it enables the surgeon to predict preoperatively whether a patient will survive carotid artery resection. In a three-year period, nine patients have survived carotid resection on the basis of favorable OPGs, without a death or permanent neurologic complication. A comparison of the results of OPG testing with intraoperative measurement of internal carotid artery pressure showed close correlation in 14 of 20 patients who were tested. Lack of correlation in four patients can be explained by the circumstances of the intraoperative test. This study's findings demonstrate that this test has high clinical reliability.

Kinking of the internal carotid artery: Clinical significance and surgical management

Observations of a series of fifteen surgically treated coiled and kinked internal carotid arteries are reported. The kinked internal carotid artery may be clinically significant and can cause cerebral infarction, even in the absence of atherosclerosis. Each patient must be thoroughly investigated and evaluated individually. One must distinguish simple tortuosity without blood flow obstruction from critical kinking of the internal carotid artery. If a patient with angiographic confirmation is symptomatic and other causes are eliminated, surgical correction should be carefully considered, especially if rotational cerebral ischemia is present. The surgical treatment of choice is resection of the redundant internal carotid artery with reimplantation and thromboendarterectomy of any associated plaque. Kinking of the internal carotid artery may lead to aneurysm formation requiring a difficult surgical resection. Although the evidence for a precise causal relationship between kinking of the internal carotid artery and cerebrovascular symptoms is sometimes difficult to establish, it is our belief that a more aggressive surgical approach may be warranted in this potentially disabling and even fatal condition.

Elective carotid artery resection.

A retrospective study of carotid artery resection disclosed a 64% mortality when resection was performed on an emergency basis, as compared with 14% when the surgery was undertaken electively. This concurs with other studies that have demonstrated increased survival rates when elective carotid artery resection has superseded carotid artery rupture, and reemphasizes the need for a more accurate means of predicting individual tolerance for loss of the carotid artery. Use of the ocular plethysmograph (OPG) is proposed as a simple and accurate means of evaluating the adequacy of collateral hemispheric blood flow to compensate for a potentially resectable carotid artery. Eleven patients have been evaluated using this technique. Nine were predicted to successfully tolerate carotid artery resection, while intolerance was predicted for the remaining two. Four of the nine patients have undergone resection of the artery with no neurologic sequelae to date.

Combined Resection of Thyroid Cancer and Common Carotid Artery Together with Transplantation of Blood Vessel

Combined Resection of Thyroid Cancer and Common Carotid Artery Together with Transplantation of Blood Vessel

Management of chemodectomas

Abstract Symptoms, diagnosis, management, and follow-up study of eight patients with chemodectomas are described. Five tumors were benign and three were malignant. Three patients died, one from the effects of the tumor. The natural history of these tumors, benign or malignant, is one of slow progression. Four patients were treated by total excision and three patients by partial excision of the chemodectoma. The common carotid, external carotid, and internal carotid artery were successively ligated in one patient with fatal outcome. Resection of the internal carotid artery should be avoided in benign tumors if possible. If resection is necessary, re-establishment of internal carotid flow is imperative. The patient's age and condition should be considered before commencing vessel replacement. Partial resection of x-ray therapy may be useful adjuvants in managing unresectable, malignant, or symptomatic chemodectomas.

Management of chemodectomas

Symptoms, diagnosis, management, and follow-up study of eight patients with chemodectomas are described. Five tumors were benign and three were malignant. Three patients died, one from the effects of the tumor. The natural history of these tumors, benign or malignant, is one of slow progression. Four patients were treated by total excision and three patients by partial excision of the chemodectoma. The common carotid, external carotid, and internal carotid artery were successively ligated in one patient with fatal outcome. Resection of the internal carotid artery should be avoided in benign tumors if possible. If resection is necessary, re-establishment of internal carotid flow is imperative. The patient's age and condition should be considered before commencing vessel replacement. Partial resection of x-ray therapy may be useful adjuvants in managing unresectable, malignant, or symptomatic chemodectomas.

Carotid body tumor: Report of case treated by resection of tumor and carotid artery followed by replacement of artery with frozen dried graft

1. 1. A case is reported in which removal of a carotid body tumor necessitated sacrifice of the carotid artery. 2. 2. The carotid artery was replaced with a frozen dried graft, and one year after operation the patient is well.