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Revascularization of the Internal Carotid Artery for Isolated, Stenotic, and Symptomatic Kinking
Giulio Illuminati, MD;
Francesco G. Calió, MD;
Vassilios Papaspyropoulos, MD;
Giuseppe Montesano, MD;
Antonio D'Urso, MD
Arch Surg. 2003;138:192-197.
Hypothesis The operation for isolated, stenotic, and symptomatic kinking of the internal carotid artery is safe and effective in preventing stroke and relieving the symptoms of cerebral ischemia.
Design A consecutive sample clinical study with a mean follow-up of 44 months.
Setting The surgical department of an academic tertiary care center and an affiliated secondary care center.
Patients Fifty-four patients with a mean age of 67 years underwent 55 revascularizations of the internal carotid artery. The surgical procedures consisted of the following: shortening and reimplantation in the common carotid artery in 36 cases, bypass grafting in 15 cases, and transposition into the external carotid artery in 4 cases.
Main Outcome Measures Cumulative survival, primary patency, and stroke-free and neurologic symptom-free rates expressed by standard life-table analysis.
Results No patients died in the postoperative period. The postoperative stroke rate was 1.8%. The cumulative rates (SEs) at 5 years were as follows: survival, 70% (10.2%); primary patency, 89% (7.8%); overall stroke free, 92% (6.8%); ipsilateral stroke free, 96% (5.3%); neurologic symptom free, 90% (7.5%); and ipsilateral symptom free, 93% (6.5%).
Conclusion Revascularization of the internal carotid artery for the treatment of isolated, stenotic, and symptomatic kinking is safe and effective in preventing stroke and relieving symptoms of cerebrovascular insufficiency.
From the "Francesco Durante" Department of Surgical Sciences and Applied Technologies, University of Rome "La Sapienza," Rome, Italy (Drs Illuminati, Papaspyropoulos, Montesano, and D'Urso), and the Unit of Vascular Surgery, Sant'Anna Hospital, Catanzaro, Italy (Dr Calió).
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