Arteriography after carotid endarterectomy

Completion imaging techniques and their clinical role after carotid endarterectomy: Systematic review of the literature

“…Almost half of the patients (4949; 44%) were treated for symptomatic disease. In Table 4, the type of CEA is 36 EJVES 1996 Prospective 100 TCD and angioscopy and duplex scan Lohr et al 37 Cardiovascular Surgery 1995 Retrospective 168 Arteriography Lingenfelter et al 38 Ann Vasc Surg 1995 Prospective 50 Duplex scan and arteriography Branchereau et al 39 Ann Vasc Surg 1995 Prospective 96 Angioscopy Hoff et al 40 EJVES 1994 Prospective 44 Duplex scan and arteriography Baker et al 41 JVS 1994 Retrospective 283 Duplex scan Kinney et al 42 JVS 1993 Prospective 430 Duplex scan (142), duplex scan and arteriography (268), or clinical inspection (51) Donaldson et al 43 ANNALS OF SURGERY 1992 Retrospective 410 Arteriography Sawchuk et al 44 JVS 1989 Retrospective 80 Duplex scan Bredenberg et al 45 JVS 1989 Retrospective 50 Arteriography Schwartz et al 9 JVS 1988 Prospective 76 Duplex scan Alpert et al 17 JVS 1984 Retrospective 40 Arteriography Holder et al 46 AJNR described. Most of the patients were treated under general anesthesia (64%; 4309/6724).…”

“…Arteriography provides the benefit of the assessment of the intracranial circulation in addition to the extracranial arteries. 44 ----------Bredenberg et al 45 ----------Schwartz et al 9 64 ---------Alpert et al 17 Na ---------Holder et al 46 60 Furthermore, it provides better assessment of the presence of flap or insufficient endarterectomy in the distal part of endarterectomy site, in particular in the presence of high bifurcation or of a kink. [14][15][16][17] The DUS technique provides the advantage of the hemodynamic assessment of a residual stenosis, in addition to other morphological findings.…”

“…Each technique used different criteria to assess the presence of major or minor defect. Thus, in angiography, three categories were identified: normal, irregular wall 40 38 patch 17 7 12 3 -40 Baker et al 41 -------Kinney et al 42 264 patch 184 106 74 97 GA 420 Donaldson et al 43 -167 41 79 -GA 78 Sawchuk et al 44 -------Bredenberg et al 45 25 patch-25 primary 41 5 -4 GA -Schwartz et al 9 71 primary 36 11 -11 81% local -Alpert et al 17 26 primary; 14 patch ------Holder et al 46 - 15 Retrograde direct puncture of the common carotid with a 21-gauge needle -Sharpe et al 18 The lumen of the endarterectomy zone was then inspected with a flexible hysteroscope (Olympus 1070-48)…”

Surgical Techniques from Intraoperative Angiographic and Velocimetric Controls in 43 Consecutive Carotid Bifurcation Endarterectomies

“…Carried out as a matter of routine, this test provides indication of the need for immediate CE correction in variable though significant percentages, between 5 % and 25 % approximately. 5,8,[15][16][17][18][19][20][21][22] It also permits detection of spasms distal to the arteriotomy, which are a possible cause of acute thrombosis.23…”

Doppler ultrasound assessment of the internal carotid artery following carotid endarterectomy.

“…3,4 It is also associated with complications 5 ' 6 and therefore is not routinely used to assess the patency of the internal carotid artery in asymptomatic patients following ca rotid endarterectomy. 7 Angiography performed soon after carotid surgery can provide unreliable information, which may be due to tissue fragmentation and oedema of the vessel wall. 8 Postoperative angiograms were performed by Schultz and his colleagues 9 who reported that of eleven internal carotid arteries shown to have irregular walls at this time, four were found to be smooth on angiograms performed after a further six months.…”