Ramon Berguer, MD, PhD, J.A. Gonzalez, MD Journal of Vascular Surgery

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Presentation transcript:

Revascularization by the retropharyngeal route for extensive disease of the extracranial arteries Ramon Berguer, MD, PhD, J.A. Gonzalez, MD Journal of Vascular Surgery Volume 19, Issue 2, Pages 217-225 (February 1994) DOI: 10.1016/S0741-5214(94)70097-4 Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Arteriogram of patient with left hemisphere symptoms and two previous operations for myocardial revascularization. Left common carotid and subclavian arteries are occluded. Retropharyngeal bypass from right subclavian artery to left carotid bifurcation was done. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Schematic representation of operations done in this series. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Carotid-carotid transposition. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Right external carotid to left internal carotid retropharyngeal bypass with use of saphenous vein. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 (A), Oblique end-to-end anastomosis to posterior aspect of carotid bulb. (B) End-to-end anastomosis to distalmost common carotid artery after eversion endarterectomy of carotid bifurcation. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 (A) Patient with occluded internal carotid arteries bilaterally and common carotid artery on left. Single stenotic vertebral artery (arrow) is only direct supply to brain. (B) Intraoperative arteriogram after retropharyngeal bypass to first segment of left subclavian artery and eversion endarterectomy of left vertebral lesion. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 (A) Patient with occluded internal carotid arteries bilaterally and common carotid artery on left. Single stenotic vertebral artery (arrow) is only direct supply to brain. (B) Intraoperative arteriogram after retropharyngeal bypass to first segment of left subclavian artery and eversion endarterectomy of left vertebral lesion. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Life table analysis of primary patency for retropharyngeal reconstructions. Numbers indicate patients at risk. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 8 Life table analysis of survival for retropharyngeal reconstructions. Numbers indicate patients at risk. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 9 Distance between common carotid arteries measured straight across retropharyngeal space and curving in front of airway. Journal of Vascular Surgery 1994 19, 217-225DOI: (10.1016/S0741-5214(94)70097-4) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions