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This book addresses multiple principles of carotid endarterectomy in terms of cervical anatomy, surgical techniques, practical cases and frequent questions stemming from clinical practice. Carotid endarterectomy (CEA) is an effective way to the treatment of carotid artery stenosis, which significantly reduce the risk of stroke. This book covers the key concepts and common question in CEA. It is a practical book focusing on basic surgical technical techniques, but not covers controversial issues.
Detailed discussion of evaluation, management, and post-operative care You'll find information on state-of-the-art techniques, imaging modalities, and current evaluation issues in carotid artery surgery. Plus, this book provides the endovascular data which has been missing in carotid textbooks until now. Highlights of this work: Detailed analysis of the latest techniques, including endovascular procedures and special methods of carotid reconstruction Collaboration between neurosurgeons, vascular surgeons, radiologists, and other surgical groups provides the most complete review of the field available The most up-to-date information on diagnosis, imaging, preoperative evaluation, and perioperative monitoring Insightful discussion of controversial issues in surgical management, post-operative care, and the future of carotid endarterectomy The modern guide to carotid artery surgery... Carotid Artery Surgery's interdisciplinary approach makes it the state-of-the-art reference for any specialist who deals with carotid endarterectomy. The book brings together the newest information in the field and points the way to future developments. Neurosurgeons, vascular surgeons, and neurologists, among others, will find this book to be an interesting, as well as valuable reference.
The efficiency of carotid surgery on an asymptomatic carotid artery stenosis and its superiority to conservative treatment was clearly demonstrated in the ACAS study. The stroke risk over a five year follow-up period could be reduced by 55 % and the combined stroke and mortality rate was shown to be a mere 2. 3 %. The efficacy of surgical treatment in also reducing stroke rates in the case of a symptomatic carotid stenosis was proven in the NASCET and ECTS prospective randomized studies. Of extreme importance in these procedures is, however, precise quality control and quality assessment. This is presently a topic of tremendous interest in reconstructive vascular surgery and is constantly being discussed in specialist circles and beyond. Documentation and the possibility of accurate reconstruction of the intraoperative situation are in high demand. Perioperative monitoring of neurological function, particularly the monitoring during carotid surgery, are the aspects underlying constant revision and reassessment to ensure quality control and assurance of a negligeable mortality and morbidity rate. The aim of this book is to discuss the presently available perioperative control methods, examinations, and quality assessments, and the critical consideration of these. We would like to express our thanks to all authors who helped achieve the sense and aim of this book. A special word of thanks to Dr. Kerstin Simons (assistant surgeon) for assisting in the editing of the numerous presentations in this book. Particularly we thank Dr.
Here's 30 insightful debates on the most frequently encountered and controversial clinical issues related to the surgical management of carotid artery diseases. Leading European and North American surgeons offer their views on patient selection, preoperative management, operative technique, and post-operative care. Conclusions and management options are summarized at the end of each discussion for easy referral. This is the perfect source for evidence-based recommendations and expert opinions on the questions and problems encountered daily by vascular surgeons.
Background and Aims:The perioperative complication rate of carotid stenosis patients should be controlled in fewer than 6% of symptomatic cases and 3% of asymptomatic cases.Therefore, we evaluate various factors and select the surgical option, carotid endarterectomy (CEA) or carotid artery stenting (CAS), whichever is safer. However,in case of long carotid plaque formation, both CEA and CAS could be high risk options.Based on our clinical experience, we developed hybrid surgery combined CEA andCAS and got successful outcome.Methods:We prospectively analyzed 238 consecutive surgical cases in patients with carotid stenosis in New Tokyo Hospital, between January 2016 and December 2018. As our first option for carotid stenosis with short lesion, we choose CEA and for CEA high risk cases including re-stenosis type or long lesion type, we choose CAS.In case of long vulnerable plaque, as unusually high-risk group, we performed hybrid surgery combined CEA for vulnerable plaque part and CAS for distal or proximal part of carotid stenosis at one time.Results:We performed CEA for 185 cases, CAS for 43 cases and hybrid surgery combined CEA and CAS for 10 cases. The perioperative complication rate was 0.8% in total cases including one acute occlusion case and one postoperative bleeding case in wound area of CEA group. During postoperative 30 days, we had no cerebral infarction case or fetal case.Conclusions:We demonstrated the successful surgical outcome of carotid stenosis cases with developing hybrid surgery combined CEA and CAS.
Surgery of tje Arteries to the Head provides residents and practicing surgeons with detailed descriptions and explanations of various surgical techniques. Written in essay style, it presents an opinionated discourse based on the collective experiences of leading vascular surgeons.
In Cerebral Revascularization: Microsurgical and Endovascular Techniques, renowned surgical experts combine their expertise to provide the most current and comprehensive coverage of open brain bypass and endovascular options currently available.A detailed introduction familiarizes readers with the various indications for these technically demanding procedures. Concise chapters then supply thorough coverage of surgical strategies, complications, and outcomes using case examples from the authors' own collections to help prepare readers for surgery. Enhancing the text throughout, operative photographs and angiographic images clearly demonstrate the pre-, peri-, and postoperative management of ischemic stroke, giant aneurysms, and the spectrum of complex cerebrovascular diseases.Features Extensive coverage of extracranial-intracranial bypass and the latest in endovascular therapy 369 high-quality operative photographs and endovascular images illustrate key concepts A unique emphasis on the vital role perioperative care plays in optimizing patient outcomes Neurosurgeons, residents, and fellows will regularly refer to this definitive guide in both the operating room and the catheterization lab. It is also an indispensable resource for interventional radiologists, neurologists, vascular neurosurgeons, or for anyone who needs to learn more about these cutting-edge cerebral revascularization techniques.