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Carotid-carotid crossover bypass: is it a durable procedure?
Kathleen J Ozsvath1, Sean P Roddy, R Clement Darling
1Institute for Vascular Health and Disease, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208, USA.
Journal of Vascular Surgery
|March 6, 2003
Summary
Carotid-carotid artery crossover bypass is a safe and effective surgical option for treating carotid artery disease, avoiding median sternotomy. This procedure offers durable results with good stroke-free survival rates.
Area of Science:
- Vascular Surgery
- Cerebrovascular Surgery
- Surgical Outcomes
Background:
- Reconstruction of the common carotid artery often requires direct repair via aortic artery-based revascularization.
- Carotid-carotid artery crossover grafting presents an alternative extra-anatomic approach, bypassing the need for median sternotomy.
Purpose of the Study:
- To analyze the outcomes of carotid-carotid artery crossover bypass surgery.
- To evaluate the safety, durability, and stroke-free survival of this extra-anatomic bypass technique.
Main Methods:
- A retrospective analysis of patients undergoing carotid-carotid crossover bypass from 1995 to 2000.
- Data collection included demographics, surgical indications, perioperative outcomes, and graft patency.
- Stroke-free survival and graft patency were assessed using life table methods.
Main Results:
- Twenty-four carotid-carotid bypass procedures were performed for symptomatic and asymptomatic disease.
- No perioperative deaths occurred; morbidity included one early occlusion, one transient neurologic deficit, and one stroke.
- Long-term follow-up showed 88% primary and 92% secondary graft patency at 3 years, with 94% stroke-free survival at 4 years.
Conclusions:
- Carotid-carotid artery crossover bypass surgery is a safe and durable procedure.
- This technique effectively avoids median sternotomy.
- Acceptable stroke-free survival rates support its use in select patients.