الفهرس | Only 14 pages are availabe for public view |
Abstract Prevention of stroke is the primary objective of carotid endarterectomy in patients with carotid occlusive lesions. CEA represents a safe and more effective alternative to anticoagulant or antiplatelet medical treatment. The indications for operative treatment were: Symptomatic patients with lesion causing 50% or more stenosis. Patients with crescendo TIAs in presence of 50% stenosis or more. A symptomatic patient with ulcerative lesion of carotid artery (large or complicated ulcer (C ulcer). Hemispheric cerebrovascular accident with complete recovery. Carotid duplex ultrasound is very effective tool in screening high-risk patients and its accuracy was high as compared with operative finding, so duplex ultrasound should be the primary tool for invetsigation before deciding surgery for the patients. MR Angiography and CT angiography is a very helpful tool as a non-invasive diagnostic technique; it over comes the complications of conventional angiography. The choice of patch material depends on other factors as the availabilty of long saphenous vein or the need of the vein for later coronary or limb revasculariation for the patient. However, saphenous vein patching is superior to PTFE patch as regard less thrombogenicity of its surface and more resistance to infection. The harvest of small part of long saphenous vein in the lower leg is more economic and more superior than PTFE patch with good results as regards below out and dilatation so, it is recommended to close arteriotomy with saphenous patch after CEA. |