https://unilib.phaidrabg.rs/o:2904 doi:10.1016/j.avsg.2017.05.023 cobiss:125380361 ISSN: 0890-5096 BACKGROUND: To date, all published studies analyzing simultaneous treatment of carotid and proximal atherosclerotic lesions are describing retrograde approach and several technical variations. In the presented study, for the first time, antegrade approach is described for simultaneous carotid endarterectomy (CEA) and associated brachiocephalic trunk (BCT) or common carotid artery (CCA) angioplasty in the hybrid operating room. METHODS: From January 2012 till January 2016, antegrade hybrid procedures were performed in 18 patients. All patients were admitted to our institute for elective supraaortic arch multidetector computed tomography angiography when significant simultaneous proximal and distal supraaortic arch lesions were revealed. After surgical exposure of carotid arteries, proximal lesions were crossed by antegrade approach. Prior to stent placement, internal carotid artery (ICA) is clamped at its origin with the guidewire placed in the external carotid artery (ECA). After primary stenting and control arteriography, CCA and ECA are clamped and the ICA clamp moved more distally. An arteriotomy is performed in the CCA, with flushing of possible debris and thrombus before performance of the eversion CEA, once again flushing before completion of the anastomosis. Follow-up ranged from 6 to 36 months with average follow-up of 22.15 ± 11.31 months. RESULTS: All procedures went uneventfully. Out of 18 patients, 11 were males and 7 females, mean age 66.6 ± 3.82 years. In 10 patients (55.5%), simultaneous CEA and CCA angioplasty was performed, in 7 patients (38.9%) CEA and BCT angioplasty, and in 1 patient (5.5%) tubular graft interposition between the CCA and the ICA and CCA angioplasty. In 6 patients (33.3%), CCA/BCT balloon angioplasty alone was performed simultaneously with CEA. None of the patient had postoperative transient ischemic attack, stroke, hematoma, dissection, myocardial infarction, or ischemia in the early postoperative period and during the follow-up. There were no lethal outcomes, neither in the early postoperative course nor during the follow-up. CONCLUSIONS: Antegrade approach for simultaneous treatment of proximal CCA/BCT and distal carotid lesions with temporary ICA clamping is safe and feasible procedure that should be thought of in the future in addition to already described retrograde approach. info:eu-repo/semantics/article eng application/pdf 875477 bytes 2017 Radak, Đorđe Tanasković, Slobodan Sagić, Dragan Antonić, Želimir Gajin, Predrag Babić, Srđan Nešković, Mihailo Matić, Predrag Kovačević, Vladimir Nenezić, Dragoslav Ilijevski, Nenad Annals of Vascular Surgery(44) A novel antegrade approach for simultaneous carotid endarterectomy and angioplasty of proximal lesions in patients with tandem stenosis of supraaortic arch vessels http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode Podaci o licenci i pravu pristupa prema https://v2.sherpa.ac.uk/id/publication/10584