Endarterectomy and saphenous vein Y patchplasty technique for severe carotid artery bifurcation lesion

Abstract

Arteriosclerosis, is mostly affect coronary and carotid arteries especially the ostium and bifurcation due to the nature of the flow. Arterial bifurcation lesions cause dilemma for the treating physician during both surgical and invasive procedures because they require a higher clinical experience and longer processing time. In carotid artery surgery, it is accepted that patchplasty prevents perioperative and postoperative restenosis, and as a result of this, it reduces the incidence of ipsilateral stroke. In the present time synthetic patch materials (PTFE, Dacron) and autologous patch materials (saphenous and jugular veins) are used. We report a case of carotid endarterectomy and ‘Y\' shaped saphenous patchplasty to the carotid bifurcation. According to our research in the literature, we didn\'t find any case with ‘Y\' shaped saphenous vein patch. There was only one Y shaped carotid patchplasty case by using PTFE material. Our original technic is advantageous in terms of easy preparation and application as well as its successful outcome.

Keywords

• Carotid artery diseases, saphenous vein, patchplasty

Ciddi karotis bifürkasyon lezyonunda endarterektomi ve safen ven ile ‘Y\' patchplasti tekniği

Abstract

Arterioskleroz nedeni tam olarak bilinmemekle birlikte en sık koroner ve karotis arterleri etkilemekte, akım özelliklerinden dolayı ise en sık damar ostiumları ve bifurkasyon düzeylerinde görülmektedir. Arteriyel bifurkasyon bölgesindeki lezyonlar tedavi eden hekim için problemdir, çünkü hem cerrahi hem de invazif girişimler esnasında ayrı bir tecrübe ve daha uzun işlem süresi gerektirir. Karotid arter cerrahisinde patchplasti uygulanmasının perioperatif ve geç dönem restenozları ve dolayısı ile de tek taraflı inme riskini azalttığı düşünülmektedir. Yama materyali olarak sentetik (polytetrafluoroethylene [PTFE], Dacron) ve otolog (Safen ven, juguler ven) materyaller kullanılmaktadır. Biz burada; karotis bifürkasyon bölgesine endarterektomi ve ‘Y\' şeklinde safen patch ile anjiyoplasti yaptığımız bir vakayı sunduk. Literatürde yaptığımız araştırmalar neticesinde, bu tarz safen venden hazırlanmış ‘Y\' şeklinde patch ile yapılmış karotis patchplastiye rastlamadık. Sadece sentetik materyalden hazırlanmış ‘Y\'şeklinde patch, bir olguda karotis arterde kullanılmıştır. Sunduğumuz teknik literatürde ilk olması nedeniyle orijinal olmakla beraber hem hazırlaması ve uygulaması kolay hem de sonuç olarak yüz güldürücüdür.

Keywords

• Karotid arter hastalıkları, safen ven, patchplasti

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