T. Zielinski et al., Persistent dissection of carotid artery in patients operated on for type Aacute aortic dissection - carotid ultrasound follow-up, INT J CARD, 70(2), 1999, pp. 133-139
Citations number
15
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Over a period of 5 years, 124 patients were operated on at the National Ins
titute of Cardiology in Warsaw for acute aortic dissection, 27 of whom died
. The 97 patients discharged from the hospital were included in the present
analysis. The age of the patients ranged from 25 to 73 years with a mean o
f 50+/-10 years. Ultrasound examination of carotid arteries was performed w
ith the patient lying on his back using a Toshiba 340A color Doppler system
with a linear array probe of 7.5 MHz. Of the 97 patients examined, 15 (15%
) had a dissection of at least one of the common carotid arteries (CCA). Tw
o had Marfan syndrome. In 11 patients the dissection involved the right com
mon carotid artery and in four it involved both the left and right common c
arotid arteries. The flow in the true lumen of CCA and ICA was preserved in
all patients and the degree of narrowing ranged from 30 to -70%. Only one
of the 15 patients with CCA dissection had an ipsilateral neurological defi
cit which was already present before the aortic aneurysm operation. Ultraso
und follow-up was performed in all patients with the CCA dissection found o
n first examination. The mean duration of follow-up was 21 months. In 14 pa
tients the degree and extent of the dissection as well as the narrowing of
the true lumen was comparable, and in one patient the false channel closed
spontaneously. During follow-up there were no new major neurological events
despite the persistence of the CCA dissection with different degrees of na
rrowing of the true lumen. Doppler ultrasound examination of the carotid ar
teries can supply additional information about the extent of the dissection
, and help to assess the flow in the persisting 'double channel' common car
otid artery during the follow-up of patients. (C) 1999 Elsevier Science Ire
land Ltd. All rights reserved.