Boris Apsen Repetitorij Vie Matematike 2.pdf
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Boris Apsen Repetitorij Vie Matematike 2.pdf
Boris Apsen Repetitorij Vie Matematike 2.pdf
ISBN: 1-85584-057-8 or 1-85584-047-6 · DOB VIRTISÂ .Internal mammary arterial injury during carotid endarterectomy: incidence, mechanisms and clinical implications.
The aim of the study was to investigate the incidence of internal mammary artery (IMA) injury during carotid endarterectomy (CEA). Twenty-six consecutive patients were enrolled in the study. The mechanisms of IMA damage were classified as arterial injury during dissection (n = 12), embolism during declamping (n = 12), direct injury (n = 2) or inadvertent ligation (n = 2). IMA cross-clamping time was >60 sec in 20 patients. The overall incidence of IMA injury was 26.9%, with a significant difference between patients with a short IMA clamping time (60 sec, 32%; P = 0.05) and patients with a patient who had left main stenosis (36% vs. 16%; P = 0.045). There was no difference between patients with a short IMA clamping time and those with a lesion of the common or bifurcation carotid artery (P > 0.05). In patients with concomitant lesion of the carotid sinus and the internal carotid artery, IMA injury was observed in 14.3% and in 50% of patients with a proximal stenosis of the internal carotid artery, respectively. Overall, IMA injury was associated with significantly more severe stenosis (P 0.05). In selected patients with a high incidence of carotid artery stenosis, IMA cross-clamping time is an important risk factor for IMA injury. When IMA clamping time is >60 sec, surgeons should consider performing a procedure on the ipsilateral internal carotid artery, leaving the contralateral IMA in situ.
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