Biomedical subjects
T J Bast
Publications and source records attributed to T J Bast.
[One stage operation of bilateral carotid lesions (author's transl)].
Bilateral one stage carotid endarteriectomy was performed in 11 patients presenting with bilateral symptomatics stenoses without neurological nor cardiac major complications. We only found one such experience in the literature (1). The choice of a simultaneous procedure is based solely on electroencephalogram analysis and on the residual pressure after the test of carotid occlusion; the side where occlusion is tolerated and/or where the residual pressure is highest, is operated first. This simultaneous bilateral procedure carries the theoretical risk of ischemia. It has the advantage of decreasing the cardiac complications and the risk of neurological deficit and at the same token avoids intercurrent controlateral thrombosis and recurrent symptoms between two non-simultaneous procedures. In cases of symptomatic lesions, the indication of surgery is evident; for asymptomatic lesions we only consider a simultaneous procedure in special cases where there exists a threat of neurological complications.
Surgical treatment of patients with a carotid artery occlusion and a contralateral stenosis.
Patients with a carotid artery occlusion and a haemodynamically significant contralateral stenosis have an increased risk of incurring a stroke. Based on the results of a series of 33 patients our conclusion is that the surgical therapy of choice should be endarterectomy of the stenotic artery irrespective of which side the symptoms are located on. Only those patients who continue to have TIA's on the side of the occlusion after endarterectomy of the stenotic side should be considered for an ECIC bypass.
A comparison of conventional and digital intravenous arteriography in the follow-up of femoro-crural bypass operations.
The value of intravenous arteriography, otherwise known as digital vascular imaging (DVI) in the late postoperative control of femoro-crural bypass operations is determined by comparing its results with those of conventional arteriography. Ten patients with 12 grafts were studied by both methods after a mean postoperative follow-up period of 83.5 months. DVI was 100% accurate in the determination of graft patency. In most patients it provided reliable information regarding the status of the distal anastomosis and the patency of the distal runoff. Since DVI has been proven accurate, has a good patient acceptance, and can be performed as an outpatient procedure, it is preferable to conventional arteriography for the objective documentation of long-term graft patency.