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Reducing the risk of carotid surgery: A 7-year audit of the role of monitoring and quality control assessment  A.Ross Naylor, MDa, Paul D. Hayes, FRCSa,

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Presentation on theme: "Reducing the risk of carotid surgery: A 7-year audit of the role of monitoring and quality control assessment  A.Ross Naylor, MDa, Paul D. Hayes, FRCSa,"— Presentation transcript:

1 Reducing the risk of carotid surgery: A 7-year audit of the role of monitoring and quality control assessment  A.Ross Naylor, MDa, Paul D. Hayes, FRCSa, Holger Allroggen, MRCPb, Nikki Lennard, FRCSa, Michael E. Gaunt, MDa, Matthew M. Thompson, MDa, Nicholas J.M. London, MDa, Peter R.F. Bell, MDa  Journal of Vascular Surgery  Volume 32, Issue 4, Pages (October 2000) DOI: /mva Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

2 Fig. 1 Top left, Hysteroscope used during intraoperative angioscopy. Top right, Completion angioscopy study of endarterectomy zone and distal ICA shows possible plane of dissection under intima; this was corrected surgically. Bottom left, Mural thrombus adherent to endarterectomy zone, adjacent to proximal common carotid step. Bottom right, Thrombotic material retrieved from endarterectomy zone after angioscopy. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

3 Fig. 2 Normal completion angioscopy.
Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

4 Fig. 3 Bleeding vasa vasorum (arrow) that is source of luminal thrombus in endarterectomy zone. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions

5 Fig. 4 A, Effect of dextran on embolus count in early postoperative period in patient who had postoperative embolic stroke on day 5 (case 10, Table III). Within 4 hours, embolization had ceased, and no neurologic deficit occurred. B, On day 5, patient had upper limb monoparesis and was found to be embolizing profusely. Dextran was again administered (50 mL/h), rate of embolization decreased rapidly, and patient made significant clinical recovery (OHS score of 1 at 30 days). Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2000 Society for Vascular Surgery and The American Association for Vascular Surgery, a Chapter of the International Society for Cardiovascular Surgery Terms and Conditions


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