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Carotid bypass with polytetrafluoroethylene grafts: a study of 110 consecutive patients  Christophe Camiade, MD, Amer Maher, MD, Jean-Baptiste Ricco, MD,

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Presentation on theme: "Carotid bypass with polytetrafluoroethylene grafts: a study of 110 consecutive patients  Christophe Camiade, MD, Amer Maher, MD, Jean-Baptiste Ricco, MD,"— Presentation transcript:

1 Carotid bypass with polytetrafluoroethylene grafts: a study of 110 consecutive patients 
Christophe Camiade, MD, Amer Maher, MD, Jean-Baptiste Ricco, MD, Jérôme Roumy, MD, Guillaume Febrer, MD, Christophe Marchand, MD, Jean-Philippe Neau, MD  Journal of Vascular Surgery  Volume 38, Issue 5, Pages (November 2003) DOI: /S (03)

2 Fig 1 Proximal anastomosis of PTFE graft. A, After systemic heparinization (50 UI/kg), common carotid artery is clamped at base of neck, about 4 cm below carotid bifurcation. Arteriotomy is performed on common carotid artery, and end-to-side anastomosis is made between PTFE graft and common carotid artery. B, After terminating anastomosis, internal carotid artery is clamped 2 to 3 cm distal to atherosclerotic lesion. Any air or debris within the lumen is evacuated through unattached end of PTFE graft before restoring flow in common carotid artery and external carotid artery. C, Distal anastomosis of PTFE bypass graft is made as follows. Internal carotid artery is clipped immediately distal to atherosclerotic lesions, and arteriotomy is made on internal carotid artery. End-to-side distal anastomosis is made between PTFE graft and internal carotid artery. After flushing, suture line is tied under pressure, and clamp is removed from internal carotid artery. Journal of Vascular Surgery  , DOI: ( /S (03) )

3 Fig 2 In severe common and external carotid artery stenosis (A), amputation of origin of internal carotid artery is necessary, (B), followed by localized endarterectomy in common and external carotid arteries. Arteriotomy is closed with direct suture. Journal of Vascular Surgery  , DOI: ( /S (03) )

4 Fig 3 Intraoperative arteriography of a prosthetic internal bypass with endarterectomy and patch of the external carotid artery, as described in Fig 2. Journal of Vascular Surgery  , DOI: ( /S (03) )

5 Fig 4 Cumulative survival rate with 95% confidence interval. The number of patients at risk for each interval is given. Cumulative survival rate was 81.4 ± 11% at 3 years. Journal of Vascular Surgery  , DOI: ( /S (03) )

6 Fig 5 Bypass graft patency rate with 95% confidence interval. The number of patients at risk for each interval is given. Cumulative patency was 95.0 ± 5.7% at 3 years. Journal of Vascular Surgery  , DOI: ( /S (03) )

7 Fig 6 Kaplan-Meier stroke-free rate with 95% confidence interval. The number of patients at risk for each interval is given. Stroke-free rate was 97.7 ± 2.3% at 3 years. Journal of Vascular Surgery  , DOI: ( /S (03) )

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