Progress in carotid artery surgery at the base of the skull

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Presentation transcript:

Progress in carotid artery surgery at the base of the skull Wilhelm Sandmann, M.D., Michael Hennerici, M.D., Albrecht Aulich, M.D., Horst Kniemeyer, M.D., Karl W. Kremer, M.D.  Journal of Vascular Surgery  Volume 1, Issue 6, Pages 734-743 (November 1984) DOI: 10.1016/0741-5214(84)90003-X Copyright © 1984 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 A, Carotid angiogram demonstrating fibromuscular dysplasia in 38-year-old woman after minor stroke. B, Patient was admitted for TIAs 7 years later. On follow-up angiogram tortuosity ending with distal aneurysm can be seen. C, Artery was resected and replaced by saphenous vein graft. D, Specimen contained embolic source. Journal of Vascular Surgery 1984 1, 734-743DOI: (10.1016/0741-5214(84)90003-X) Copyright © 1984 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 A, Angiograms of 26-year-old man with isolated kinking stenosis that resulted in minor stroke. B, Diseased segment was resected and replaced by saphenous vein graft. Patient remains asymptomatic after 2 years. Journal of Vascular Surgery 1984 1, 734-743DOI: (10.1016/0741-5214(84)90003-X) Copyright © 1984 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 A, Posttraumatic changes in 42-year-old engineer 7 years after blunt trauma in neck. B, Patient was readmitted after recurrent stroke and aneurysm was resected and replaced by saphenous vein segment. C, Resected aneurysm was partially thrombosed, explaining recurrent ischemic cerebral symptoms from embolism. Journal of Vascular Surgery 1984 1, 734-743DOI: (10.1016/0741-5214(84)90003-X) Copyright © 1984 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 A, Subtotal occlusion of ICA within carotid canal in 39-year-old anesthesiologist 3 years after blunt trauma due to karate sport. B, Underlying disease was chronic dissection, which became obvious after removal of thrombus by balloon catheter. Journal of Vascular Surgery 1984 1, 734-743DOI: (10.1016/0741-5214(84)90003-X) Copyright © 1984 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Angiograms of 15-year-old diabetic boy presenting with symptoms of trigeminus neuralgia from large mycotic aneurysm following recurrent tonsillitis. Outflow segment was stenosed and opening of carotid canal was required for distal anastomosis. Postoperative angiogram 14 days after operation shows normal graft function. Patient has been asymptomatic for 3 years. Journal of Vascular Surgery 1984 1, 734-743DOI: (10.1016/0741-5214(84)90003-X) Copyright © 1984 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 A, Chronic dissection in 42-year-old woman suffering from stroke and recurrent TIAs. B, Intraoperative arteriogram was obtained to assure patency of distal anastomosis at carotid foramen. C and D, Retrograde transbrachial angiograms were obtained 14 days after operation demonstrating patency of graft. Journal of Vascular Surgery 1984 1, 734-743DOI: (10.1016/0741-5214(84)90003-X) Copyright © 1984 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions