| Preface to the Third Edition |
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xiii | |
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Chapter 1 Foundation and Evidence for Carotid Reconstruction |
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2 | (55) |
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2 | (1) |
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Scientific Foundation for Carotid Artery Treatments |
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2 | (14) |
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Best Medical Therapy (Asymptomatic or Symptomatic) |
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3 | (1) |
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Asymptomatic Carotid Disease |
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3 | (1) |
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3 | (2) |
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Contralateral Carotid Stenosis |
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5 | (1) |
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Carotid Risks in Non-Carotid Pre-Operative Patients |
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6 | (1) |
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6 | (1) |
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Symptomatic Carotid Disease |
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7 | (1) |
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Transient Ischemic Attacks |
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8 | (1) |
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Acute Neurological Deficit |
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9 | (1) |
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Subacute Complete Carotid Occlusion |
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10 | (1) |
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11 | (1) |
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Special Considerations with Recent Stroke |
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11 | (1) |
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11 | (1) |
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Special Surgical Considerations |
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12 | (1) |
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Plaque Ulceration and Stroke Risk Markers |
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12 | (1) |
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12 | (1) |
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Intra-Luminal Thrombus (ILT) |
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12 | (1) |
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Contralateral Carotid Occlusion |
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13 | (1) |
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Tandem Lesions of the Carotid Siphon |
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14 | (1) |
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Concurrent Carotid Disease and Intra-Cranial Aneurysm |
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14 | (1) |
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Recurrent Carotid Stenosis |
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14 | (1) |
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Concurrent Coronary/Carotid Disease |
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15 | (1) |
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16 | (14) |
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16 | (1) |
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Local/Regional Anesthesia |
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16 | (2) |
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18 | (1) |
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Monitoring Techniques during Carotid Cross-Clamping |
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18 | (1) |
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Monitoring Techniques under GA |
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19 | (8) |
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27 | (1) |
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28 | (1) |
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28 | (1) |
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29 | (1) |
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29 | (1) |
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29 | (1) |
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30 | (1) |
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30 | (1) |
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Surgical Technique of Cervical Carotid Reconstruction |
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30 | (6) |
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30 | (1) |
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Pre-Operative Studies and Preparation |
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31 | (1) |
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31 | (5) |
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36 | (2) |
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Micro-Surgical Endarterectomy |
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36 | (1) |
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Bilateral Carotid Endarterectomy |
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37 | (1) |
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37 | (1) |
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37 | (1) |
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Post-Operative Considerations |
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38 | (1) |
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Complications of Carotid Revascularization |
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38 | (2) |
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38 | (1) |
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Complications Following Surgery |
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39 | (1) |
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Endovascular Treatment of Carotid Stenosis |
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40 | (4) |
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41 | (1) |
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41 | (2) |
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43 | (1) |
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44 | (13) |
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Chapter 2 Historical Perspective and Current Practice of Carotid Artery Stenting (CAS) |
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57 | (18) |
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Historical Review and Recent Evidence |
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58 | (3) |
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(1) Less Favorable Studies for CAS |
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58 | (1) |
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(2) More Favorable Studies for CAS |
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59 | (1) |
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60 | (1) |
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(4) Comparative Study with Medical Treatments |
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60 | (1) |
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Techniques for Carotid Artery Stenting |
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61 | (5) |
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Techniques to Address Peri-Procedural Risk Management in CAS |
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61 | (1) |
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(1) Antiplatelet Therapy (Thromboembolic Risk) |
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61 | (1) |
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(2) 3D-CTA for Evaluation of Access Routes (Anatomical Risk) |
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62 | (1) |
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(3) Assessment of Cardiac Function (Cardiac Risk) |
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62 | (2) |
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(4) Plaque Images (Plaque Risk) |
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64 | (1) |
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(5) Evaluation of Cerebral Blood Flow (CBF) Risk |
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64 | (2) |
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Technical Considerations during the CAS Procedure |
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66 | (4) |
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66 | (1) |
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66 | (1) |
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(3) Embolic Protection Methods |
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66 | (1) |
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67 | (2) |
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(5) Standard Procedure of CAS |
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69 | (1) |
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Summary of Settings and Monitoring |
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69 | (1) |
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70 | (1) |
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Post-Operative Monitoring |
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70 | (1) |
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Follow-Up of the Patients |
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70 | (1) |
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(6) Special Considerations |
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70 | (1) |
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Two-Staged Angioplasty for Patients with High Risk for Post-Procedural Hyperperfusion Syndrome |
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70 | (1) |
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70 | (1) |
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71 | (4) |
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Chapter 3 Radiographic Studies |
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75 | (57) |
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3-1 Low Bifurcation of the Carotid Artery with Symptomatic Plaque Just at the Origin of the Internal Carotid Artery |
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76 | (2) |
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3-2 High Bifurcation of the Cervical Carotid Artery |
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78 | (2) |
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80 | (2) |
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3-4 Focal Internal Carotid Artery Ulcer |
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82 | (2) |
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3-5 Deep Ulceration of a Carotid Plaque |
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84 | (2) |
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3-6 Benign Arteriogram---Bad Ulceration |
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86 | (2) |
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3-7 Ninety-Five Percent Lesion |
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88 | (2) |
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3-8 Extensive Plaque in Common Carotid Artery with Long Arteriotomy |
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90 | (2) |
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92 | (2) |
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3-10 X-Ray Identification of an Ascending Pharyngeal Artery Originating at the Carotid Bifurcation |
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94 | (2) |
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96 | (2) |
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3-12 Cross Filling into Contralateral Middle Cerebral Artery |
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98 | (2) |
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3-13 Can We Predict the Need for Shunting? |
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100 | (2) |
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3-14 Pre-Operative External Carotid Artery Occlusion |
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102 | (2) |
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3-15 Internal Carotid Stump |
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104 | (2) |
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106 | (2) |
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3-17 Carotid Stenosis with Distal Cervical Aneurysm |
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108 | (2) |
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3-18 Intra-Luminal Thrombus |
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110 | (2) |
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3-19 Complication---Clot along Suture Line |
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112 | (2) |
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3-20 Complication---Complete Post-Operative Occlusion |
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114 | (2) |
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3-21 Complication---External Carotid Artery Dissection |
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116 | (2) |
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3-22 Morphology and Plaque Content |
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118 | (14) |
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118 | (1) |
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118 | (2) |
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18F-Fluorodeoxyglucose (FDG) PET |
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120 | (1) |
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120 | (1) |
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15O Positron Emission Tomography (PET) |
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120 | (2) |
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Single Photon Emission Tomography (SPECT) |
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122 | (1) |
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Hyperperfusion Syndrome after CEA/CAS |
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123 | (1) |
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Non-Invasive MRA and CTA for Surgical Planning |
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124 | (5) |
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129 | (3) |
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Chapter 4A Surgical Technique -- Christopher Loftus |
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132 | (211) |
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132 | (2) |
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134 | (2) |
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136 | (2) |
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4-4 Side-by-Side Positioning |
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138 | (2) |
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4-5 Incision for High Bifurcation |
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140 | (2) |
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4-6 Ease of Dissection and Exposure |
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142 | (2) |
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4-7 Draped and Ready for Incision |
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144 | (2) |
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4-8 Platysma with Michel Clips |
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146 | (2) |
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4-9 External Jugular Vein |
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148 | (2) |
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4-10 Sternocleidomastoid Muscle |
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150 | (2) |
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4-11 Jugular Vein---Common Facial Vein |
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152 | (2) |
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4-12 Ligation of the Common Facial Vein |
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154 | (2) |
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4-13 Secure Ligation of the Common Facial Vein |
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156 | (2) |
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4-14 Minor Branches of Facial Vein |
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158 | (2) |
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4-15 Dissection behind the Parotid Gland |
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160 | (2) |
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4-16 First Demonstration of Common Carotid Artery with Control |
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162 | (2) |
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4-17 First CCA Control with 0 Silk Tie and Rummel Tourniquet |
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164 | (2) |
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4-18 Exposure of Carotid Artery with Retractors |
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166 | (2) |
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4-19 Ring Clamp and Blunt Fish-Hook Retraction for Total Carotid Exposure |
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168 | (2) |
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4-20 Four Sutures in the Carotid Sheath |
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170 | (2) |
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4-21 Unexpected Internal Carotid Artery Atresia |
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172 | (2) |
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4-22 Thyroid Mass Found at Time of CEA---Right-Sided Exposure |
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174 | (2) |
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4-23 Major Nerve Structures Potentially Injured during Carotid Endarterectomy |
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176 | (2) |
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4-24 Other Nerves at Risk during Carotid Endarterectomy |
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178 | (4) |
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4-25 Low Bifurcation with Omohyoid Muscle |
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182 | (2) |
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4-26 Isolation of Omohyoid |
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184 | (2) |
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186 | (2) |
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4-28 Division of Omohyoid Muscle to Secure Adequate Low Carotid Exposure |
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188 | (2) |
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190 | (2) |
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4-30 Sternomastoid Artery---An External Carotid Artery Branch |
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192 | (2) |
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4-31 High Bifurcation with Digastric Muscle and Hypoglossal Nerve---Left Carotid Exposure |
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194 | (2) |
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4-32 High Bifurcation with Digastric Muscle and Hypoglossal Nerve---Right Carotid Exposure |
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196 | (2) |
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4-33 Side-by-Side Carotid Anatomy---Exposure |
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198 | (2) |
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4-34 Isolation of Superior Thyroid Artery---Right Carotid Exposure |
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200 | (2) |
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4-35 Isolation of Superior Thyroid Artery---Left Carotid Exposure |
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202 | (2) |
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4-36 Isolation of Ascending Pharyngeal Artery (Left) |
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204 | (2) |
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4-37 Isolation of Ascending Pharyngeal Artery (Right) |
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206 | (2) |
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4-38 Clues to the End of the ICA Plaque |
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208 | (2) |
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4-39 Tactile and Visual End of Plaque---Left Carotid Exposure |
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210 | (2) |
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4-40 Tactile and Visual End of Plaque---Right Carotid Exposure |
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212 | (2) |
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4-41 Doppler Auscultation for Extent of Plaque |
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214 | (2) |
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4-42 Extensive Plaque Erosion into the Adventitial Layer |
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216 | (2) |
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4-43 Javid Clamp around Internal Carotid Artery |
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218 | (2) |
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220 | (2) |
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4-45 Placement of Cross-Clamp below Rummel Tourniquet |
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222 | (2) |
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4-46 Incision along Common and Internal Carotid Arteries (Blue Line)---Left Carotid Exposure |
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224 | (2) |
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4-47 Potts Scissors Opening---Left Carotid Exposure |
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226 | (2) |
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4-48 Potts Scissors Opening Vessel---Left Carotid Exposure |
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228 | (2) |
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4-49 False Plane Demonstrated with Penfield Retractor---Right Carotid Exposure |
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230 | (2) |
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4-50 Focal Plaque in Proximal Internal Carotid Artery---Left Carotid Exposure |
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232 | (2) |
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4-51 Long, Extensive Common Carotid Artery/Internal Carotid Artery Plaque |
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234 | (2) |
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4-52 Shunt in Common Carotid Artery / Internal Carotid Artery |
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236 | (2) |
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4-53 Initial Placement of Shunt Down Common Carotid Artery |
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238 | (2) |
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4-54 Securing of Shunt in Common Carotid Artery |
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240 | (2) |
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4-55 Bleeding and Evacuation of Shunt before Placement in Internal Carotid Artery |
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242 | (2) |
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4-56 Placement of Shunt in Distal Internal Carotid Artery |
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244 | (2) |
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4-57 Potential for Intimal Damage from Placement of Shunt |
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246 | (2) |
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4-58 Securing of Shunt in Internal Carotid Artery |
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248 | (2) |
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4-59 Loftus-Type Carotid Shunt in Place---Two Views |
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250 | (2) |
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4-60 Evaluation of Shunt Function |
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252 | (2) |
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4-61 Repair with Shunt in Place |
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254 | (2) |
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4-62 Plaque Removal Begins at Lateral Edge---Left Carotid Exposure |
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256 | (2) |
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4-63 Sharp Transection in Common Carotid Artery---Right Carotid Exposure |
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258 | (2) |
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4-64 Sharp Scissors Transection of CCA Plaque |
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260 | (2) |
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4-65 Plaque Removal from Internal Carotid Artery (Feathered Edge)---Right Carotid Exposure |
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262 | (2) |
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4-66 Plaque Removal from External Carotid Artery---Left Carotid Exposure |
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264 | (2) |
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4-67 Opening of External Carotid Artery---Part 1: Inadequate Feathering |
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266 | (2) |
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4-68 Opening of External Carotid Artery---Part 2: Inadequate Feathering |
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268 | (2) |
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4-69 Opening of External Carotid Artery Because of Poor Doppler Signal |
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270 | (2) |
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4-70 Opening of External Carotid Artery---Repair |
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272 | (2) |
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4-71 Completed External Carotid Artery Repair in a Case with Internal Carotid Artery Hemashield Patch |
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274 | (2) |
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4-72 Removal of Fragments in Circumferential Fashion---Right Carotid Exposure |
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276 | (2) |
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4-73 Left Carotid Endarterectomy---Completed Removal, Sharp Margins |
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278 | (2) |
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4-74 Completed Removal, Sharp Margins---Left Carotid Exposure |
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280 | (2) |
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4-75 Placement of Tacking Sutures in Internal Carotid Artery |
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282 | (2) |
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4-76 ICA Single Posterior Tacking Suture |
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284 | (2) |
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4-77 Clean Edges at Both CCA and ICA---Ready for Repair |
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286 | (2) |
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4-78 Anatomic Variant---Atherosclerotic Web on Posterior Wall of Vessel |
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288 | (2) |
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4-79 Repair Beginning in Internal Carotid Artery: Left Carotid Exposure---No Patch Graft |
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290 | (2) |
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4-80 "No Touch" Technique for the Prolene Suture |
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292 | (2) |
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4-81 Microscopic Internal Carotid Artery Repair |
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294 | (2) |
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4-82 Repair Beginning in External Carotid Artery: Right Carotid Exposure---No Patch Graft |
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296 | (2) |
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4-83 Repair of External Carotid Artery: Left Carotid Exposure---No Patch Graft |
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298 | (2) |
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4-84 Second Limb of Repair Coming Up Common Carotid Artery---No Patch Graft |
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300 | (2) |
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4-85 Suture Sequence and Placement of the Hemashield Roof Patch Graft on the Internal Carotid Artery |
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302 | (4) |
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306 | (2) |
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4-87 Tying Together---Evacuation of Air: Right Carotid Exposure |
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308 | (2) |
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4-88 Blunt Needle to Evacuate Air and Debris as Final Step---Patch Graft |
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310 | (2) |
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4-89 Four Rip-Stop Free Sutures in the Patch Repair |
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312 | (2) |
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4-90 Sequence of Clamp Removal at Completion of Arteriotomy |
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314 | (2) |
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4-91 Doppler Examination of Repair: Left Carotid Exposure |
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316 | (2) |
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4-92 Completed Dry Repair without and with Hemashield Patch Graft |
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318 | (8) |
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4-93 Y-Shaped Suture Line---No Patch Graft |
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326 | (2) |
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4-94 FloSeal for Hemostasis in the Carotid Bed |
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328 | (2) |
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4-95 Surgicel on Dry Repair |
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330 | (2) |
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332 | (2) |
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334 | (2) |
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336 | (2) |
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338 | (2) |
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4-100 Placement of Saphenous Vein Patch Graft |
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340 | (3) |
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Chapter 4B Surgical Technique -- Satoshi Kuroda |
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343 | (26) |
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4-101 General Anesthesia and Skin Incision |
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344 | (1) |
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345 | (1) |
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4-103 Sternocleidomastoid Muscle and Great Auricular Nerve |
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346 | (1) |
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4-104 Carotid Sheath and Internal Jugular Vein |
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347 | (1) |
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4-105 Opening of Carotid Sheath |
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348 | (1) |
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349 | (1) |
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350 | (1) |
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4-108 Part 1: Dissection of Common Carotid Artery from Carotid Sheath |
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351 | (1) |
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4-109 Part 2: Dissection of Common Carotid Artery from Carotid Sheath |
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352 | (1) |
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4-110 Carotid Sinus Nerve Blockade |
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353 | (1) |
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354 | (1) |
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4-112 Incision along Common and Internal Carotid Arteries |
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355 | (1) |
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4-113 Insertion of Shunt Tube into Internal Carotid Artery |
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356 | (1) |
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4-114 Insertion of Shunt Tube into Common Carotid Artery |
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357 | (1) |
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4-115 Observation of Plaque Content |
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358 | (1) |
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4-116 Start of Endarterectomy |
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359 | (1) |
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4-117 Endarterectomy on the Opposite Side |
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360 | (1) |
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4-118 Sharp Transection in Common Carotid Artery |
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361 | (1) |
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4-119 Sharp Transection in Internal Carotid Artery |
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362 | (1) |
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4-120 Sharp Transection in External Carotid Artery |
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363 | (1) |
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4-121 Placement of Tacking Suture in Internal Carotid Artery |
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364 | (1) |
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4-122 Primary Closure in Internal Carotid Artery |
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365 | (1) |
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4-123 Primary Closure in Common Carotid Artery |
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366 | (1) |
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4-124 Removal of Internal Shunt Tube |
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367 | (1) |
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4-125 Final View of Operative Field |
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368 | (1) |
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369 | (22) |
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5-1 Stab Wound of Posterior Carotid Wall |
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370 | (2) |
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5-2 Acute Post-Operative Internal Carotid Artery Thrombosis |
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372 | (2) |
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5-3 Technique for Exploration of Complete Carotid Occlusion |
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374 | (2) |
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5-4 Use of Fogarty Catheters to Re-Open Thrombosed Internal Carotid Artery |
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376 | (2) |
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5-5 Post-Operative Wound Hematoma |
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378 | (2) |
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5-6 Aneurysm Formation 4 Years Post-Operatively |
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380 | (2) |
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5-7 Post-CEA Hyperperfusion Syndrome |
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382 | (2) |
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5-8 Post-CEA Occlusion of External Carotid Artery |
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384 | (2) |
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5-9 Post-CEA/CAS DWI-Positive Lesions |
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386 | (2) |
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5-10 Femoral Artery Pseudo-Aneurysm after Catheter Insertion |
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388 | (3) |
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390 | (1) |
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391 | (28) |
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6-1 Treatment of Isolated Common Carotid Artery Stenosis |
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392 | (2) |
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6-2 Treatment of "Stump" in an Occluded Internal Carotid Artery |
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394 | (4) |
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6-3 Repair and Straightening of a Large Left Carotid Kink |
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398 | (2) |
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6-4 Rapid Recurrence of Stenosis from Myointimal Hyperplasia |
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400 | (2) |
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6-5 Scarring in the Carotid Sheath in a Case of Recurrent Stenosis |
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402 | (2) |
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6-6 Re-Operation in a Case Previously Repaired with a Saphenous Vein Roof Patch |
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404 | (3) |
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6-7 Mild Carotid Stenosis with Repeated Stroke |
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407 | (4) |
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6-8 Invasion of Inflamed Plaque into the Media and Adventitia |
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411 | (4) |
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6-9 Cervical Carotid Aneurysm Associated with Marfan Syndrome |
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415 | (4) |
| Reference |
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419 | (2) |
| Index |
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421 | |