Surgery of the Arteries to the Head

1 Historical Notes.- The Late Development of Vascular Repairs in the Neck.- 2 The Aortic Arch and Its Branches: Anatomy and Blood Flow.- Anterior System (Internal Carotid Arteries).- Posterior System (Vertebrobasilar Arteries).- Failsafe System (External Carotid Arteries).- Intracranial and Extracranial Connections.- Flow Patterns in Aortic Arch Branches.- Regulation of Cerebral Blood Flow.- 3 Arterial Lesions and Patterns of Disease.- Lesions in the Arterial Wall.- Patterns of Disease.- 4 Mechanisms of Ischemia.- Hemodynamic Mechanism.- Embolic Mechanism.- Acute Cerebral Ischemia.- 5 Presentation and Selection of Patients.- Clinical Syndromes.- Patient Selection.- 6 Surgical Maneuvers.- Ligation/Intravascular Occlusion.- Classic Reconstructive Techniques.- Intraluminal Dilatation.- Transposition Techniques.- 7 Repair of the Supraaortic Trunks.- Transthoracic Repairs.- Cervical Bypass.- Transpositions.- 8 Repair of the Internal and External Carotid Arteries.- Methods of Cerebral Protection.- Exposure of the Carotid Bifurcation.- Standard Endarterectomy of the Internal Carotid Bifurcation.- Eversion Endarterectomy of the Carotid Bifurcation.- Correction of Redundancy.- Bypass of the Internal Carotid Artery.- Steps to Enlarge Distal Exposure.- Reconstruction of the External Carotid Artery.- 9 Repair of the Vertebral Artery.- Reconstruction of the Proximal Vertebral Artery.- Reconstruction of the Distal Vertebral Artery.- 10 Complex Repairs.- Combined Repair of the Carotid-Vertebral/Subclavian Arteries.- Reconstruction of all Proximal Trunks.- Combined Intrathoracic and Cervical Operations.- Combined Cerebrovascular and Coronary Artery Reconstruction.- Combined Cerebrovascular and Aortic/Peripheral Vascular Reconstruction.- 11 Special Surgical Problems.- Trauma.- Aneurysmal Disease.- Takayasu’s Arteritis.- The Retroesophageal Subclavian Artery.- Fibromuscular Dysplasia.- Spontaneous Dissections.- Radiation Arteritis.- Arteriovenous Fistula.- Carotid Body Tumors and Other Paragangliomas.- Innominate-Tracheal Fistula.- 12 Complications.- Stroke.- Thrombosis.- Dissection.- Bleeding.- Infection.- Complications Specific to the Surgical Approach.- 13 Reoperations.- Reoperations on the Supraaortic Trunks.- Reoperations on the Internal Carotid Artery.- Reoperations on the Vertebral Artery.- 14 Epilogue.- 15 Bibliography.