EŞ ZAMANLI YAPILAN KAROTİS ENDARTEREKTOMİ VE KORONER ARTER BY-PASS GREFT AMELİYATINDA ALTERNATİF BİR KAROTİS YAMA OLARAK OTOLOG PERİKARD KULLANIMI Usage of Autologous Pericardıum as an Alternative Carotid Patch in Concomitant Carotid Endarterectomy and Coronary Artery By-Pass Graft Surgery

Yıl 2019, Cilt: 9 Sayı: 1, 58 - 63, 26.03.2019

Veysel Başar Hakan Hançer

Öz

Karotis arter darlığı, iskemik inmenin başlıca nedenlerinden biridir. Karotis endarterektomi

(CEA), karotis arter darlığı için başlıca iki tedavi seçeneğinden biridir. Ameliyatın son aşamasında,

primer sütür ile ve ya sentetik (PTFE ve Dacron) veya otolog (safen ve boyun damarları) greftleri

ile arteriyotomi kapatılması yapılabilir. Bu olgu sunumunda, greft yokluğu durumunda eşzamanlı

yapılan CEA ve koroner arter by-pass greftleme cerrahisi esnasında karotis arteriotomi

kapatılması için otolog perikardiumun patch-greft olarak kullanıldığı dört ayrı olguyu sunmayı

amaçladık.

Anahtar Sözcükler: Endarterktomy; Perikardium; Otolog; Graft; Patch

ABSTRACT

Carotid artery stenosis is one of the main causes for ischemic stroke. Carotid endarterectomy

(CEA) is one of the two major treatment options for carotid artery stenosis. Arteriotomy closure

at the last phase could be performed with primary suturing and also either with synthetic (PTFE

and Dacron) or autologous (saphenous and neck veins) grafts. In this case-report; we aimed

to present four seperate cases in which we used autologous pericardium as a patch-graft for

carotid arteriotomy closure in concomitant CEA and coronary artery by-pass graft surgery

(CABG) in consequence of graft absence.

Keywords: Carotid, Endarterectomy; Pericardium; Autologous; Graft; Patch

Anahtar Kelimeler

EŞ ZAMANLI YAPILAN KAROTİS ENDARTEREKTOMİ VE KORONER ARTER BY-PASS GREFT AMELİYATINDA ALTERNATİF BİR KAROTİS YAMA OLARAK OTOLOG PERİKARD KULLANIMI Usage of Autologous Pericardıum as an Alternative Carotid Patch in Concomitant Carotid Endarterectomy and Coronary Artery By-Pass Graft Surgery

Kaynakça

• 1. Jones EL, Craver JM, Michalik RA, Murphy DA, Guyton RA, Bone DK, Hatcher CR, Reichwald NA. Combined Bozoğlan O ve ark. Koroner ve Karotis Arter Hastalığında Kombine Cerrahi Abant Med J 2012;1(3 110 ):107-110 carotid and coronary operations: When are they necessary? J Thorac Cardiovasc Surg 1984;87:7-16 2. Faggioli GL, Curl GR, Ricotta JJ. The role of carotid screening before coronary artery bypass. J Vasc Surg 1990;12:724-31. 3. Akins LW, Moncure AC, Daggett WM. Safety and efficiency of concomitant carotid and coronary artery operations. Ann Thorac Surg 1995;60:311-8 4. Stone PA, Aburahma AF, Mousa AY, et al. Prospective randomised trial of ACUSEAL versus Vascu-Guard patching in carotid endarterectomy. Ann Vasc Surg 2014; article in press 5. Ren S, Li X, Wen J. Zhang W, Liu P. Systematic review of randomized controlled trials of different types of patch materials during carotid endarterectomy. PLoS One 2013;8: e55050 6. Abu Rahma AF, Hannay RS, Khan JH, Robinson PA, Hudson JK, Davis EA. Prospective randomized study of carotid endarterectomy with polytetraflouroethylene versus collogen-impregnated Dacron (Hemashield) patching: perioperative (30-day) results. J Vasc Surg 2002; 35:125-30 7. Grego F, Antonello M, Lepidi S, Bonvini S, Deriu GP. Prospective, randomized study of external jugulear vein patch versus polytetraflouroethylene patch during carotid endarterectomy: perioperative and long-erm rsults. J Vasc Surg 2003; 38: 1232-40 8. Bond R, Rerkasem K, Naylor AR, Aburahma AF, Rothwell PM. Systematic review of randomised controlled trials of patch angioplasty versus primary closure and different types of patch materials during carotid endarterectomy: J Vasc Surg 2004: 40: 26-35 9. De Bakey ME. Successfull carotid endarterectomy for cerebrovascular insufficiency: Nineteen-year follow-up. JAMA 1975;233:1083-5. 10. Yıldırım T, Akgün S, Sur H, Kınıkoğlu H, Bilgin F, Arsan S. Eş zamanlı karotis endarterektomi ile miyokardiyal revaskülarizasyonun erken dönem sonuçları. Turkish J Thorac Cardiovasc Surg 2004;12:156-60.