Surgical Treatment of Cervical Carotid Occlusive Lesions : A Review-I Complete Occlusion

The author presents a review of published literatures on the surgical treatment of atherosclerotic occlusive lesions at the cervical carotid bifurcation. This review is an analysis of progress in the past and predictable development in the near future, rather than a comprehensive report of the literature. The review will be made in three parts. In this first part, attention was focused on the surgical treatment of "total occlusion" of the internal carotid artery. The analysis included such surgical procedures as endarterectomy of the contralateral carotid stenosis, endarterectomy of the external carotid artery, stumpectomy and other techniques in addition to EC-IC bypass operation. The author chosen particularly to emphasize the importance of cerebral blood flow measurement as an adjunct to the objective selection of "total occlusion" patients for the surgical treatment. Limitted usefulness of presently available rCBF method was discussed in comparison with feasibility of "Xe-enhanced CT scan" method