The management of stenotic and obstructive lesions of the aortic arch branches

Shumacker, Harris B.; Isch, John H.; Jolly, Walter W.; Fitzgerald, Ella

doi:10.1016/0002-9610(77)90544-x

Cited by 10 publications

(2 citation statements)

References 32 publications

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“…Axillary-axillary bypass grafts, subclavian-subclavian bypass grafts, carotid-subclavian bypass grafts, carotid-carotid bypass grafts, and subclavian-carotid transposition have been used to treat proximal great vessel disease, with variable results. [14][15][16][17][18][19][20][21][22][23][24] We reviewed our experience with carotid-carotid bypass procedures, specifically analyzing complications, patency, operative mortality, and stroke-free survival associated with this approach.…”

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confidence: 99%

Carotid-carotid crossover bypass: Is it a durable procedure?

Ozsvath

Roddy

Darling

et al. 2003

Journal of Vascular Surgery

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confidence: 99%

Carotid-carotid crossover bypass: Is it a durable procedure?

Ozsvath

Roddy

Darling

et al. 2003

Journal of Vascular Surgery

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“…Traditional surgical treatment of great-vessel occlu- sion involves extraanatomical reconstruction procedures such as subclavian-carotid bypass, carotid-carotid crossover bypass, and direct repair via median sternotomy. 3,11 The rate of perioperative stroke and death from these procedures varies from 0 to 6.3% in published series. 12,13 Several previous reports have described a combined approach (carotid endarterectomy with endovascular angioplasty and stent placement) for treatment of CCA stenosis.…”

Section: Discussionmentioning

confidence: 99%

Combined surgical and endovascular approach to treat symptomatic in-stent occlusion of the left common carotid artery origin

Shah

Memon

Tummala

et al. 2009

JNS

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Symptomatic occlusive lesions at the origins of the supra-aortic vessels pose challenges for treatment. Endovascular angioplasty and stent placement via the transfemoral approach is possible, but obtaining a stable position for the guide catheter via this approach is technically difficult. The authors describe the case of a 56-year-old man presenting with symptomatic occlusion of a previously placed stent at the origin of the left common carotid artery (CCA). An endovascular revascularization of the left CCA was planned. However, the absence of a lumen proximal to the stent prevented stable placement of a guide catheter via the transfemoral route. Consequently, the authors used a combined surgical and endovascular approach to gain access to the lesion. The left CCA was exposed surgically distal to the occlusion and clamped just proximal to its bifurcation to preserve flow from the external to the internal carotid artery (ICA) and to prevent embolism into the ICA. A wire was passed retrograde through the occlusive lesion and then was subsequently advanced proximally into the femoral sheath. This allowed transfemoral advancement of the appropriate endovascular devices to perform an angioplasty and placement of a stent. The patient remained neurologically stable, and postoperative studies showed improvement in cerebral perfusion. This case demonstrates the feasibility of distal-to-proximal stent delivery with a combined endovascular and surgical approach.

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