Carotid endoarterectomy in the presence of contralateral XXXX .

@entity1 @entity64 @entity12705 @entity75 @entity7908 @entity432 @entity715 @entity543
BACKGROUND: The purpose of this study was to define a correct anesthesiological and surgical approach in @entity1 who present a significant @entity543 with contralateral @entity432 . METHODS: Between 1996 and 1998 in our Department of Vascular Surgery of the Hospital S. Giovanni Battista has been executed 337 Carotid Endoarterectomies (CEA). Of these, 44 @entity1 (13%) had a contralateral internal @entity432 . Forty was male (91%), and 4 female (9%). Echo Doppler, angiography, angioTC or angio-RMN and @entity12705 were performed in all @entity1 . In all cases was executed a traditional CEA. RESULTS: Because of the presence of a large @entity75 or clamping intolerance 12 operation were performed under general anesthesia (27%). Shunt was used in 15 @entity1 (34%) and patch was used in 10 cases (23%). In 2 cases (4.5%) there was be a @entity715 of the operated internal carotid artery and one @entity1 died (2.3%). CONCLUSIONS: The presence of contralateral internal @entity432 with @entity543 > 70% increase the risk of @entity64 because of the difficulty of collateral cerebral blood flow. The execution of echo Doppler, angiography, angioTC or angioRM and @entity12705 and their evaluation permit to choice the best anesthesiological and surgical treatment. The utilization of @entity7908 with thiopental protection and shunting reducing the rate of perioperative @entity64 , but the local anesthesia allows the best monitoring of intraoperative cerebral function. This behaviour was correctly when in @entity1 with contralateral internal @entity432 there is an insufficient intracranic vascularization or an extensive @entity75 or clamping intolerance.
