ABSTRACT
BACKGROUND: Eversion carotid endarterectomy (ECEA) is a technique that obviates the need for traditional longitudinal arteriotomy and patch closure, with low stroke and restenosis rates. The aim of the present study was to report an Australian experience and technique of ECEA. METHODS: All patients who underwent ECEA by the investigating surgeons between October 1997 and July 2000 were followed up clinically and with duplex ultrasound. The technique of ECEA is described. RESULTS: One hundred and fifty-two ECEA were performed, 13 combined with coronary artery bypass grafting (CABG). The combined perioperative stroke and death rate was 2%; 0.65% excluding CABG combined cases. This compares with 2.9% for standard carotid endarterectomy throughout Victoria. Significant restenosis occurred in 2.6% after a mean follow up of 21.7 months. CONCLUSION: ECEA is a simple and safe alternative to standard carotid endarterectomy.
Subject(s)
Carotid Artery, Internal , Carotid Stenosis/surgery , Endarterectomy, Carotid/methods , Aged , Carotid Stenosis/diagnostic imaging , Endarterectomy, Carotid/adverse effects , Female , Humans , Male , Ultrasonography, Doppler, DuplexABSTRACT
Mycotic aneurysms of the extracranial carotid arteries are rare, with only 27 cases reported in the English literature. The causative organism is most frequently Staphylococcus but infections due to Streptococcus, Salmonella and Klebsiella have been reported. Escherichia coli has been reported as the causative organism in three cases. Mycotic aneurysms usually present in the setting of generalized sepsis such as postoperative infection, septicaemia, dental sepsis, drug addiction or bacterial endocarditis. We report a patient who presented with a mycotic aneurysm of the internal carotid artery 2 months after undergoing a laparotomy for perineal sepsis.
