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[Subclavian-carotid replacement in chronic cerebrovascular insufficiency management]
A B Stepanenko1, E R Charchyan1, A P Gens1
1Petrovsky Russian Research Center for Surgery, Moscow, Russia.
Aim:
To present own experience of subclavian-carotid replacement for chronic cerebrovascular insufficiency management.
Material And Methods:
For 12 years 7 subclavian-carotid reconstructions were performed that was 1.2% of all carotid repairs during this period. Great saphenous vein was always used as a graft. Carotid endarterectomy from proximal internal carotid artery was additionally performed if it was necessary. Patients had severe advanced lesion of supra-aortic vessels including bilateral carotid lesion and significant stenosis of ipsilateral proximal common carotid artery. The vast majority of them had cerebrovascular insufficiency grade 3-4.
Results:
All patients underwent surgery without significant complications despite initially severe state due to advanced lesion of brachiocephalic arteries. Long-term postoperative patency of the grafts was satisfactory within the period from 12 years to 1.5 months. There were no neurological impairment and stroke.
Conclusion:
Subclavian-carotid grafting is an effective alternative for carotid endarterectomy in patients with advanced atherosclerotic lesion of common and internal carotid arteries.
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