SUCCESSFUL REVASCULARIZATION FOR UNSTABLE ANGINA OF A PATIENT WITH ASYMPTOMATIC BILATERAL INTERNAL CAROTID OCCLUSION, 70-PERCENT STENOSES OF THE EXTERNAL CAROTID ARTERIES, AND OTHER CIRCULATION DISTURBANCES
Br. Osswald et al., SUCCESSFUL REVASCULARIZATION FOR UNSTABLE ANGINA OF A PATIENT WITH ASYMPTOMATIC BILATERAL INTERNAL CAROTID OCCLUSION, 70-PERCENT STENOSES OF THE EXTERNAL CAROTID ARTERIES, AND OTHER CIRCULATION DISTURBANCES, The thoracic and cardiovascular surgeon, 45(4), 1997, pp. 200-203
Nowadays, advanced surgical and anaesthesiological techniques of coron
ary artery bypass grafting minimize the risk of severe complications i
n patients with advanced arteriosclerotic cerebrovascular disease. Nev
ertheless, in case of highly compromized cerebrovascular status, the d
ecision whether to undertake coronary artery bypass grafting or not re
quires special patient-related consideration. A severe, unstable angin
a made it necessary to perform coronary bypass grafting in a patient w
ith bilateral internal carotid occlusion, a bilateral mid-stage stenos
is of both external carotid arteries, a diminished flow within the rig
ht vertebral artery, and a subsequently impaired intracranial blood fl
ow. Intraoperatively, besides the usual hemodynamic measurements, lase
r-Doppler flow probes were placed on the left and right upper temple t
o monitor relative changes of the cerebral blood supply. Using an indi
vidual perioperative management, the patient experienced a normal post
operative course and was discharged in good condition.