Repeated surgery of the extracranial arteries

Abstract

The number of reconstructive surgery on carotid and vertebral arteries increases annually in Ukraine. In some cases it does not rule out complications appearence and the need for repeated surgical interventions. Bleeding from the area of reconstruction or thrombosis (embolism) of the reconstructed artery tree with specific neurological manifestations can persists in early postoperative period. Restenoses and pseudoaneurysms are most commonly observed in the reconstruction area more later. Between 1994 and 2019, 22 patients were re-operated. Bleeding occurred in 15 patients (strained hematomas – in 13, continued bleeding through drainage in 1 and in another patient pulsatile hematoma of the neck was formed 24 days after surgery). Nine patients were reopened urgently, 5 of them had bleeding and 4 more – acute carotid thromboembolism in the reconstruction area, which was accompanied by stroke with clinical signs of neurological deficits. Three patients had late restenosis after reoperation and two cases (9.0%) suffered ischemic strokes with neurological deficits. Thus, repeated surgery on the extracranial arteries can be classified as quite complex, requiring the coordinated team effort of surgeons and anesthesiologists.