Aortobifemoral bypass surgery using mini-laparotomy technique

This study was carried out to compare mini-laparotomy technique of aortofemoral bypass with the conventional surgical procedure. Six cases of aortobifemoral bypass performed using a mini-laparotomy incision [6 cm] between year 2007 and 2009. The mean aortic cross-clamp time was 10.6 +/- 3.5 minutes and the mean duration of the operation was 95.7 +/- 28.9 minutes. In all cases, bowel sounds appeared at 4 to 10 hours postoperatively and oral nutrition was started after 24 hours. The mean hospital stay was 4.4 days. Mini-laparotomy technique is safe and effective for aortobifemoral bypass operations; with the advantages of short operation time, optimal aortic exposure, easy and safe aortic cross-clamping, limited postoperative pain and scar tissue, early mobilization and resumption of intestinal functions, and short hospitalization

Eversion carotid endarterectomy in treatment of symptomatic extracranial internal carotid artery stenosis

Carotid endarterectomy [CEA] is well established as astroke-preventive treatment. Eversion carotid endarterectomy requires transection of Internal carotid artery [ICA] at its origin, then everted to expel the tube of atheroma. The ICA is then re-implanted to the bifurcation of carotid artery. Eversion carotid endarterectomy [eCEA] may be associated with low risk of complications and arterial restenosis. This study aim to evaluate eversion carotid endarterectomy as regards simplicity of the technique, operative complications and recurrence of stroke or restenosis. 20 patients with symptomatic stenosis of extracranial ICA were admitted to Vascular Surgery Unit, with age range of 45-75 years, clinically examined, investigated and treated by eversion carotid endarterectomy from Aug. 2006-Feb. 2009 and followed up for operative complications and recurrence of stroke or stenosis of ICA for 18 months. During post operative period; Out of the 20 patients who underwent CEA, there was one case presented by haematoma [5%] and another case with temporary hypoglossal nerve affection. Apatient died after one year due to cardiac cause. There were no cases with recurrence of stroke or stenosis during the period of follow up [18 months]. The preliminary results of the carotid endarterectomy with eversion technique cleared that it's simple. safe, rapid technique with low complications rate, however longer follow up periods and extended studies are needed to confirm the Low rate of restenosis of ICA