V Benes1, M Mohapl. 1. Department of Neurosurgery, Prague, Czech Republic.
Abstract
BACKGROUND: Carotid kinking can either be a source of emboli or it may cause cerebral ischemia during head/neck rotation. Surgical techniques to correct the kink usually employ carotid cross-clamping and kink resection. In selected cases the authors used simple kink straightening and fixation. The patients treated by this method were evaluated. METHOD: Total of 42 operations in 40 patients were performed from 1984 through 1998. Mean age was 56 years, male:female ratio 1:1. Patients presented with either TIAs (n=26), minor stroke (n=13) or were asymptomatic (n=3). There were 2 distinct groups of patients. Group I. were the patients with kinking only (n=28), Group II. the patients in whom the kink was seen at the end of regular carotid stenosis. In all patients the kink was dissected free, straightened and fixed by several stitches. In the Group II. this manoeuvre followed standard carotid micro-endarterectomy. FINDINGS: Mean follow-up is 4,8 years (1-15). There was no morbidity, no mortality. Only 1 patient suffered several TIAs in the 6 months period after surgery. All patients are alive and symptom free. INTERPRETATION: In lesser kinks the simple surgical technique without cross-clamping is effective, easy and complication free.
BACKGROUND: Carotid kinking can either be a source of emboli or it may cause cerebral ischemia during head/neck rotation. Surgical techniques to correct the kink usually employ carotid cross-clamping and kink resection. In selected cases the authors used simple kink straightening and fixation. The patients treated by this method were evaluated. METHOD: Total of 42 operations in 40 patients were performed from 1984 through 1998. Mean age was 56 years, male:female ratio 1:1. Patients presented with either TIAs (n=26), minor stroke (n=13) or were asymptomatic (n=3). There were 2 distinct groups of patients. Group I. were the patients with kinking only (n=28), Group II. the patients in whom the kink was seen at the end of regular carotid stenosis. In all patients the kink was dissected free, straightened and fixed by several stitches. In the Group II. this manoeuvre followed standard carotid micro-endarterectomy. FINDINGS: Mean follow-up is 4,8 years (1-15). There was no morbidity, no mortality. Only 1 patient suffered several TIAs in the 6 months period after surgery. All patients are alive and symptom free. INTERPRETATION: In lesser kinks the simple surgical technique without cross-clamping is effective, easy and complication free.
Authors: Luigi Di Pino; Antonio G Franchina; Serena Costa; Stella Gangi; Francesco Strano; Mario Ragusa; Luca Costanzo; Corrado Tamburino; Davide Capodanno Journal: Int J Cardiovasc Imaging Date: 2020-09-10 Impact factor: 2.357