Abstract：
BACKGROUND:The results of randomized trials indicate that carotid endarterectomy, performed with a low morbidity-mortality perioperative risk, is the best therapeutic option both for patients with high-grade symptomatic and asymptomatic stenosis. Since the main operative risk is represented by embolic or hemodynamic cerebral ischemia, it appears necessary to maintain an adequate intraoperative cerebral blood flow and to carry out a meticulous endarterectomy. METHODS:On the basis of these considerations we prospectively studied a series of 100 consecutive patients operated on for high-grade carotid stenosis, by using a protocol based on: 1) an accurate selection of patients for surgery; 2) meticulous surgical technique without any shunt; 3) perioperative cerebral protection by barbiturate or propofol; 4) pre- and postoperative medical treatment of risk factors. All patients of our series performed preoperatively brain CT scan, transcranial Doppler, carotid duplex scanning, four vessel angiography, brain 99mTc-HMPAO SPECT. Eighty-two patients had symptomatic carotid stenosis ranged between 70 and 90%, 18 had carotid stenosis higher than 90%. RESULTS:In this series there have been one postoperative death due to myocardial infarction and one major stroke. CONCLUSIONS:We think that this protocol can significantly minimize risks of endarterectomy and probably maximize the benefits of surgery, also in patients with asymptomatic high-grade carotid stenosis.
journal_name
J Neurosurg Scijournal_title
Journal of neurosurgical sciencesauthors
D'Angelo V,Catapano G,Bozzini V,Catapano D,De Vivo P,Del Gaudio A,Ciritella P,Simone Pkeywords:
subject
Has Abstractpub_date
2001-09-01 00:00:00pages
157-62issue
3eissn
0390-5616issn
1827-1855journal_volume
45pub_type
杂志文章abstract：:This is a report of two cases of intramedullary arteriovenous malformations (AVMs) where computed tomography (CT) was used as a complementary diagnostic investigation. CT scan features in these two cases are briefly discussed. ...
journal_title：Journal of neurosurgical sciences
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abstract：: ...
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journal_title：Journal of neurosurgical sciences
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pub_type： 杂志文章,评审
doi：10.23736/S0390-5616.16.03431-7
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abstract：:A case of hypertensive endoventricular pneumocephalus associated with rhinoliquorrea raised after about 2 years from the application of ventriculo-peritoneal shunt for hydrocephalus by stenosis of aqueduct is presented. The causes of such complication and diagnostic possibilities to point out the fistula by CT and ven...
journal_title：Journal of neurosurgical sciences
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journal_title：Journal of neurosurgical sciences
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更新日期：2016-09-01 00:00:00
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journal_title：Journal of neurosurgical sciences
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更新日期：1993-12-01 00:00:00
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journal_title：Journal of neurosurgical sciences
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更新日期：2003-06-01 00:00:00
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pub_type： 杂志文章,评审
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journal_title：Journal of neurosurgical sciences
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更新日期：1997-12-01 00:00:00
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journal_title：Journal of neurosurgical sciences
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更新日期：1981-01-01 00:00:00
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journal_title：Journal of neurosurgical sciences
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journal_title：Journal of neurosurgical sciences
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doi：
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更新日期：2012-03-01 00:00:00
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journal_title：Journal of neurosurgical sciences
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abstract：: ...
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更新日期：1995-03-01 00:00:00
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journal_title：Journal of neurosurgical sciences
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journal_title：Journal of neurosurgical sciences
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更新日期：1980-04-01 00:00:00
abstract：:Embolization is commonly used for the treatment of brain arteriovenous malformations (AVMs) prior to stereotactic radiosurgery (SRS). Due to mixed outcomes, however, its use remains controversial. This article is a review of recent studies assessing the efficacy of pre-radiosurgical embolization for brain AVMs. Articl...
journal_title：Journal of neurosurgical sciences
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更新日期：2018-08-01 00:00:00
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