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Richard H. Whitten, MD; William Gee, MD; Harry A. Kaupp, MD; Kenneth M. McDonald, MD

Arch Surg. 1981;116(9):1165-1169.

Abstract
• Angiography documented severe ( 75%, cross-sectional area) bilateral carotid stenotic or occlusive disease in 60 patients. One third of these patients were thought to have transient ischemic symptoms of low-flow rather than embolic etiology. Preangiographic ocular pneumoplethysmography (OPG-Gee) was obtained in all patients. Postoperative OPG studies were obtained in the 39 patients who underwent unilateral carotid surgery. In seven of the 39 patients who were operated on, bilateral procedures were performed; OPG studies were obtained after the second procedure also. Comparison of the preoperative and postoperative OPG studies provided convincing evidence that the establishment of major carotid inflow should be the primary objective in patients with severe bilateral carotid disease, and that distal extracranial-intracranial reconstruction should be reserved for patients failing to respond to augmented inflow because of deficient collateral vessels.

(Arch Surg 1981;116:1165-1169)

Author Affiliations
From the Department of Surgery, Allentown and Sacred Heart Hospital Center, Allentown, Pa. Dr Whitten is now with the Memorial Hospital, Worcester, Mass.

Footnotes
Accepted for publication March 30, 1981.

Reprint requests to Department of Surgery, Allentown and Sacred Heart Hospital Center, Box 689, 1200 S Cedar Crest Blvd, Allentown, PA 18105 (Dr Gee).

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