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. 2007 Jul;17(4):229-34.
doi: 10.1055/s-2007-984485.

"Extarterectomy" for tumors invading the carotid artery: an animal model

Kazım Oner  1 , Cem Bilgen, Ismail Oran, Tayfun Kirazli, Ahmet Memiş, Izzet Ovül, Ozlem Yilmaz
Affiliations

"Extarterectomy" for tumors invading the carotid artery: an animal model

Kazım Oner et al. Skull Base. 2007 Jul.

Abstract

Objective: Carotid artery (CA) invasion by head and neck tumors is a challenging problem for the cranial base surgeon. Proposed methods for management have the disadvantage of constant or temporary interruption of the arterial blood flow and, as a consequence, cerebral ischemic complications. The objective of the study was to investigate the long-term effects of a novel technique, "extarterectomy," on the vascular wall and the arterial blood flow in an ovine model.

Methods: Wallstents were implanted bilaterally in the common CA of 5 sheep by the Seldinger technique. Six weeks after stent implantation, a segment of the arterial wall of about 2 cm in length was peeled off the external surface of the stent. Six months later, control angiography was performed. The animals were sacrificed after 18 months and the "extarterectomized" arteries were removed for the microscopic and macroscopic evaluation.

Results: There were no acquired neurological deficits in the study group. Extarterectomy was performed without any complication in every case. Control angiography confirmed patent CAs. Evaluation by light microscopy showed the "neointimal" layer within the interstices of the stent.

Conclusion: Extarterectomy allows aggressive tumor removal together with the maintenance of blood flow through the CA and offers hope for those with tumors invading the CA.

Keywords: Carotid artery; carotid stenting; head and neck cancer.

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Figures

Figure 1
Figure 1
A segment of full-thickness arterial wall being peeled off the external surface of the implanted stent.
Figure 2
Figure 2
Neointima and the stent struts seen in the extarterectomized segment of the carotid artery.
Figure 3
Figure 3
Control angiograms reveal patent carotid arteries without angiographically visible intimal thickening and aneurysm formation.
Figure 4
Figure 4
Photomicrograph shows distinct neointima formation (hematoxylin & eosin, × 20).
Figure 5
Figure 5
Half-cut view of the extarterectomized segment with the neointimal layer covering the stent. Arrows show the borders of extarterectomy.
See this image and copyright information in PMC

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