Diagnosis and Operative Management of Carotid Endarterectomy in Patients with Twisted Carotid Bifurcation.

Neurologia Medico-chirurgica
Masaaki UnoShunji Matsubara

Abstract

Although carotid endarterectomy (CEA) is an established procedure, technical modifications are required when anatomical features are unusual. The present study aimed to determine the characteristics of diagnostic features, surgical management, and outcomes of patients with a twisted carotid bifurcation (TCB). We assessed 108 consecutive patients by cervical carotid echography (CCE) and black-blood magnetic resonance imaging (BB-MRI) before they underwent 115 CEA procedures. We classified carotid bifurcation (CB) anatomy based on anteroposterior findings of the internal carotid artery (ICA) and external carotid artery (ECA) determined by cerebral or three-dimensional computed tomographic angiography as follows. The ICA and ECA ran laterally and medially, respectively, in Type 1, overlapped in Type 2, and the ICA and ECA ran medially and laterally, respectively, in Type 3. We also classified the patients according to whether or not they had a TCB and compared their diagnostic findings, clinical characteristics, and surgical outcomes. The numbers of patients with Types 1, 2, and 3 were 74 (64.4%), 32 (27.8%), and 9 (7.8%), respectively, and 13 (11.3%) with a TCB included four patients with Type 2 and all nine patients with Type 3....Continue Reading

References

Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Nov 3, 2001·Stroke; a Journal of Cerebral Circulation·U G Schulz, P M Rothwell
Mar 15, 2003·Stroke; a Journal of Cerebral Circulation·Matthias SitzerHelmuth Steinmetz
Feb 9, 2005·Neurologia Medico-chirurgica·Nakamasa HayashiShunro Endo
May 10, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Edward Y WooRonald M Fairman
Sep 24, 2010·World Neurosurgery·Hiroyuki Katano, Kazuo Yamada
Feb 28, 2017·World Neurosurgery·Shingo ToyotaTakuyu Taki
Mar 25, 2018·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Hiroki TakaiMasaaki Uno
Feb 23, 2019·World Neurosurgery·Joji TokugawaMakoto Hishii

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Citations

Aug 18, 2020·Neurologia Medico-chirurgica·Masaaki UnoShunji Matsubara
Jan 5, 2021·Neurologia Medico-chirurgica·Masaaki UnoShunji Matsubara

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