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Objective: To analyze the risk factors and short-term results of the carotid endarterectomy in our hospital. Materials and method: The present is an observational, retrospective and descriptive study, where 89 carotid endarterectomies are analyzed in a period of 8 years (January 2015 to January 2023) performed in 85 patients, the patients were divided in to two groups, symptomatic and asymptomatics, as for the complications there were divided in minor and mayor. Results: 89 carotid endarterectomies where perform between January 2015 to January 2023. In the symptomatic group are 78 (87.64%) patients, in the asymptomatic group there are 11 patients (12.35%). 62 where male (69.66%) and 27 where women (30.33%). Only 1 (1.12%) patient died, this one from the symptomatic group. Perioperatory stroke in 3 (3.37%) patients, all of them with neurologic secuela at 30 days of post operatory. 5 (5.61%) cases of post operatory hematomas 4 of them requiring reintervention. There was 1 (1.12%) patient with neurologic affection. 1 (1.12%) case of superficial wound infection. Conclusion: The carotid endarterectomy remains as the gold standard to prevent strokes in symptomatic patients. Performed in high volume centers it has excellent results as for the prevention of new strokes. [ABSTRACT FROM AUTHOR]

Introduction: In carotid surgery, proper anatomical knowledge is essential to reduce surgical time and complications. The aim of the present study is to provide landmarks for the localization of the facial vein in respect of the carotid bifurcation and its anatomical characteristics. Materials and methods: 20 carotid triangles of formalin fixed adult cadavers were dissected. The following measurements were recorded. The "carotid axis" was defined and measured as the distance in cm following the longitudinal axis of the common and internal carotid artery from the clavicle to the upper edge of the posterior belly of the digastric (L1). Distance from the carotid bifurcation to the carotid axis (L2). Distance among the facial vein and the carotid axis (L3). Distance between the facial vein and the carotid bifurcation (L4). Also, we recorded the number of tributaries received by the facial vein and the exit site. Results: L1 mean 14 cm (range 9.6-15); L2 mean 10.1 cm (range 7.5-12.5); L3 average 8.6 cm (range 5-12.6). L4 Average1.3 cm (0.2-3.1). Discussion: In most of the cases studied, the facial vein was found below the carotid bifurcation, however the distance between the two was 1.3cm on average, so we can say that they are close to each other. Conclusion: The proximity between the facial vein and the carotid bifurcation found in the present study allows us to conclude that the facial vein is potentially useful as an anatomical landmark to locate the carotid bifurcation in carotid surgery. Also, due to its proximity, the facial vein can be injured and thus lead to complications during this procedure. [ABSTRACT FROM AUTHOR]

Introduction: Between 50 and 80% of patients with a stroke, have lesions of the common or internal carotid artery, of these 15 to 30% are severely disabled, and 20% require institutionalization. Aim: To analyze the epidemiological variables involved in carotid stenosis, and the medium to long-term results of carotid endarterectomy. Materials and Method: Observational, descriptive and retrospective study, analyzed 103 successive carotid endarterectomies procedures in 97 patients, in a period of 12 years (2007 to 2018), in the Surgery Department of the Dr. Eduardo Pereira Hospital, Valparaíso, Chile. Results: Male sex 64.9%, average age 70.2 years, symptomatic 65.9%, most frequent clinical presentation, transient ischemic attack (48.4%), immediate global morbidity of the procedure 20.3%, peri-operative AVE 3.9% (none disabling), peripheral nerve dysfunction 5.8%, operative mortality < 30 days (1.9%), due to acute ischemic heart disease, with a follow-up of 100% at 12 months, no case of recurrent stenosis or pseudoaneurysm was evident, no patient died or had a long-term stroke. Discussion: The large randomized trials have demonstrated the benefit of carotid endarterectomy, in the reduction of future strokes, these benefits are maximal with stenosis > 70%, and when performed within a period less than 2 weeks of the ischemic event. Conclusion: Carotid endarterectomy remains the surgical procedure of choice, to treat severe carotid stenosis, performed in experienced centers, it is a safe and effective procedure in the prevention of cerebral ischemia. [ABSTRACT FROM AUTHOR]

Introduction: During carotid endarterectomy (CEA) clamping cerebral perfusion is maintained by contralateral circulation through the Circle of Willis and it is correlated to the stump pressure (SP). If it is below 50 mmHg there is risk of stroke due to hypoperfusion and a shunt must be used, but systemic blood pressure can be temporarily elevated making the use of shunt unnecessary. Aim: Results of CEA with SP measurement to evaluate cerebral perfusion in cross-clamped hemisphere and hemodynamic intraoperative management reducing the use of shunt. Material and Methods: Retrospective study of CEAs performed in 73 patients under general anaesthesia with SP measurement, hemodynamic management and selective use of shunt. Demographics, clinical and perioperative morbimortality variables were analized. Results: 73 patients, average age 71.1 years, 69.9% symptomatic. In 54 patients SP was above 50 mmHg and shunt was not used, in 19 SP was below 50 mmHg, it was elevated through intraoperative hemodynamic management and shunt was not needed. In only 3 cases SP did not reach 50 mmHg and a Pruitt-Inahara shunt was used. Two patients presented postoperative transient central neurological deficit and 2 died due to myocardial infarction. Conclusion: CEA with SP measurement and hemodynamic management reduced the use of carotid shunting and it was a safe procedure to treat patients with severe carotid stenosis who need surgical intervention. [ABSTRACT FROM AUTHOR]

Objective: To present the main advances and projections related with ischemic stroke management. Development: This article look at some recent aspects considered in specialized journals about: 1) Definition of stroke types, 2) Genetic risk factors of ischemic stroke, 3) Neuroimaging paradigm in ischemic stroke, 4) Telemedicine for stroke (telestroke), 5) Antithrombotic use (oral dual antiagregante therapy, periprocedural management of antithrombotic, prevention with direct action oral anticoagulants, extension of thrombolytic time to 4.5 hours after onset), 6) Evolution of approach regarding endovascular techniques, 7) Stem cells administration for brain infarction, 8) Therapies for malignant hemispheric brain edema, 9) Blood pressure levels regulation in stroke, and 10) Identification of pharmacological intervention (Selective serotonin reuptake inhibitors) for aid in motor recovery. Conclusions: A review was carried out about main advances and trends for research and clinical practice of ischemic stroke. The consideration of implementation limiting factors is vital for perfection of stroke patient management. For the implementation of this advances are required an increase consciousness and public education about stroke, protocols improvement for stroke centers, development of stroke certification process and stroke capabilities, and economic and legislative support. [ABSTRACT FROM AUTHOR]

Chronic ocular ischemia (COI) has been poorly reported in patients with carotid atherosclerotic disease (ECA) due to the fact that the early stages of this condition are usually asymptomatic or the patients are not sistematizely evaluated by expert neuro-ophthalmologists. The venous stasis retinopathy (VSR) has been referred in the literature as an important finding of the COI. We reported a patient with bilateral VSR before and after carotid unilateral endarterectomy, emphasizing the most relevant findings. [ABSTRACT FROM AUTHOR]