Important data from two large, randomized trials comparing early and late outcomes after carotid endarterectomy and carotid-artery stenting have now been published in the Journal.1,2 In common with every other large, multicenter, randomized trial to date, the Asymptomatic Carotid Trial (ACT I) and the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) showed that after the p...

Abstract Aim To compare the safety and efficacy of endovascular stenting to endarterectomy in treating femoral artery disease. Method We searched databases such as PubMed, Ovid, Embase Scopus for studies done on treatments last decade. The inclusion criteria comprised latest within 10 years, human restricting only Relevancy articles were assessed using PRISMA Newcastle-Ottawa quality assessment...

Abxtract: Cerebral Blood Flow and Internal Carotid A rtery Flow During Carotid Surgery • In a series of 17 patients operated on for stenosis of the internal carotid artery, measurement of the blood flow in the internal carotid artery by a squarewave electromagnetic flowmeter was performed simultaneously with measurement of the regional cerebral blood flow (rCBF) by the Xenon injection technique...

References 1. Dyken ML. Controversies in stroke: past and present. The Willis Lecture. Stroke. 1993;24:1251-1257. 2. Role of carotid endarterectomy in asymptomatic carotid stenosis: A Veterans Administration Cooperative Study. Stroke. 1986;17: 534-539. 3. Hobson RW II, Weiss DG, Fields WS, Goldstone J, Moore WS, Towne J, Wright CB, and the Veterans Affairs Cooperative Study Group. Efficacy of c...

Carotid endarterectomy is a commonly performed procedure for prevention of stroke related to carotid stenosis. Intraoperative sonography is used to identify potentially correctable technical defects during carotid endarterectomy. The main risk of endarterectomy is perioperative stroke, and great effort has been put into trying to reduce this risk through various surgical techniques and evaluati...

References 1. European Carotid Surgery Trialists' Group: MRC European Carotid Surgery Trial: Interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. Lancet 1991^37:1235-1243 2. North American Symptomatic Carotid Endarterectomy Trial Collaborators: Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N ...

A patient is reported who during vigorous back bleeding after unclamping of the internal carotid artery during endarterectomy had EEG slowing and a postoperative increase in neurological deficit. This phenomenon, an apparent steal, has not been reported and suggests that EEG monitoring is as vital at unclamping as it is after clamping. The patient also raises questions about the risk of early e...

We report a patient who had an 80% asymptomatic stenosis in the distal right common carotid artery with an incidental finding of an aberrant branch arising from the right common carotid artery. He underwent an elective right carotid endarterectomy with an uneventful recovery. This is the first case in the literature of a successful endarterectomy in a patient with a common carotid anomaly and i...

Current available data do not seem to support the strategy for carotid endarterectomy prior to surgical intervention in patients with asymptomatic carotid stenosis. However, in patients with coronary artery disease, synchronous carotid endarterectomy and coronary artery bypass grafting should be considered where there is a proven surgical risk of <3% with unilateral asymptomatic stenosis >60% o...

In March 1951, Fisher’s report on occlusion of the internal carotid artery characterized basic clinical and pathological features of an important disease syndrome.1 Fisher described fleeting neurological symptoms attributable to atherosclerotic narrowing, thrombosis, and cerebral embolism that might arise from thrombotic material lying in the carotid sinus. He suggested that vascular surgical b...