Carotid Artery Surgery : A Problem-Based Approach

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  • Edition: 1st
  • Format: Hardcover
  • Copyright: 2000-06-29
  • Publisher: Saunders Ltd.

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Here's 30 insightful debates on the most frequently encountered and controversial clinical issues related to the surgical management of carotid artery diseases. Leading European and North American surgeons offer their views on patient selection, preoperative management, operative technique, and post-operative care. Conclusions and management options are summarized at the end of each discussion for easy referral. This is the perfect source for evidence-based recommendations and expert opinions on the questions and problems encountered daily by vascular surgeons.

Table of Contents

Contributors vii
Foreword xi
Preface xiii
A Ross Naylor
William C Mackey
Part One Patient Selection
The randomized trials for symptomatic carotid disease: how should they influence my clinical practice?
Peter RD Humphrey
Wesley S Moore
The randomized trials for asymptomatic carotid disease: how should they influence my clinical practice?
Dafydd Thomas
Jerry Goldstone
Is there a role for emergency or urgent carotid endarterectomy
Roger M Greenhalgh
Jonathan P Gertler
William M Abbott
When should I perform carotid endarterectomy after a completed stroke?
Jens Allenberg
Hans H Eckstein
Mark W Sebastian
Anthony D Whittemore
In patients with combined carotid and coronary artery disease, should I perform a staged or synchronous procedure?
Peter RF Bell
William C Mackey
Is there a role for carotid artery surgery in patients with non-hemispheric or vertebrobasilar symptoms?
Roger M Greenhalgh
John Ricotta
Kara Kvilekval
Should cost-effectiveness influence patient selection for carotid surgery?
A Ross Naylor
Peter Rothwell
Jack L Cronenwett
John D Birkmeyer
Part Two Evaluation and Preoperative Management
Is duplex ultrasound alone sufficient for preoperative imaging?
Peter R Taylor
Andrew H Schulick
Richard P Cambria
Is there a role for preoperative magnetic resonance angiography?
Peter RD Humphery
Sheela T Patel
K Craig Kent
Which patients should undergo contrast angiography?
Torben V Schroeder
Niels Levi
Henrik H Sillesen
Patrick J Lamparello
Does routine preoperative CT scanning alter patient management?
Dafydd Thomas
Magruder C Donaldson
Which patients require preoperative assessment by a neurologist?
Dafydd Thomas
James M Estes
Which non-cardiac medical conditions alter the operative risk?
Jonathan P Thompson
Allen D Hamdan
Frank B Pomposelli Jr
When is preoperative cardiac evaluation advisable?
Jonathan P Thompson
Michael Belkin
Mark W Sebastian
What does optimal medical management really entail?
Peter RD Humphrey
Louis R Caplan
Brian Silver
Part Three Operative Care
What evidence is there that regional anaesthesia confers any benefit over general anaesthesia?
Michael Horrocks
Caron B Rockman
Thomas S Riles
What steps can I take to minimize inadvertent cranial nerve injury?
Torben V Schroeder
Niels Levi
James M Estes
What practical steps can I take if I (a) know preoperatively that the lesion extends very high or (b) unexpectedly encounter a high lesion during operation?
Peter RF Bell
Alexander D Shepard
Peter S Dovgan
What is the optimal perioperative antithrombotic regimen?
David Bergqvist
Mark W Sebastian
Michael S Conte
Should all patients be shunted? If not, how can I predict which patients will require a shunt?
Jonathan D Beard
Allen D Hamdan
Frank W LoGerfo
How can I achieve the optimal flow surface and distal end-point following carotid endarterectomy?
Nicholas JM London
Joseph P Archie Jr
Should all patients be patched? If not, how should I select which patients to patch?
Hakan Parsson
David Bergqvist
Hugh A Gelabert
When should I abandon a planned endarterectomy?
Nicholas JM London
Jonathan P Gertler
Is there any evidence that perioperative monitoring and quality control assessment alter clinical outcome?
A Ross Naylor
D Preston Flanigan
Is there a role for carotid angioplasty or stenting?
Jonathan D Beard
Robert W Hobson II
Part Four Postoperative Management
How should I manage the patient who suffers a perioperative neurological deficit?
A Ross Naylor
David Rosenthal
How can I balance patient safety and cost-effectiveness in planning early postoperative care and hospital discharge?
Peter R Taylor
Paul E Collier
Does serial postoperative clinical or duplex surveillance reduce the long-term stroke risk?
Jonathan D Beard
William C Mackey
When should I reoperate for recurrent carotid stenosis?
Michael Horrocks
G Patrick Clagett
How should I manage a patient with an infected prosthetic patch?
Peter RF Bell
Bruce A Perler
Index 397

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