[Extracranial carotid artery bypass using artificial vessels--4 case reports]

We successfully completed extracranial carotid artery reconstruction in four cases (case 1: arteriosclerotic occlusion of the left common carotid artery between the origin at the aorta to just below the cervical bifurcation, case 2-4: combined removal of the carotid artery with malignant cervical tumor) using various types of synthetic vessels, e.g. 1) Double Velour Dacron, or 2) Expanded polytetrafluoroethylene. In case 2, Xenon CT under balloon occlusion was useful for revealing the indication for carotid artery reconstruction. Recent progress in the development of materials for use in synthetic vessels has remarkably improved the long-term patency of synthetic vessels, especially in medium to large size ones (larger than 6 mm in diameter). Synthetic vessels have the following advantages: 1. No need to harvest autogenous vessels, 2. An external shunt is available for patients with poor ischemic tolerance to temporary occlusion of the carotid artery, 3. A vessel of the most suitable size can be selected, 4. No risk of tumor invasion, 5. Easy suturing because the orifice of a synthetic vessel does not collapse. We report the usefulness, the indication for, and the surgical procedures of extracranial carotid artery bypass using synthetic vessels.