Adventitial stripping for carotid sinus syndrome

Ann Vasc Surg. 2009 Jul-Aug;23(4):538-47. doi: 10.1016/j.avsg.2008.11.008. Epub 2009 Jan 8.

Abstract

Patients with a carotid sinus syndrome (CSS) suffer from spells of dizziness and loss of conscience due to an exaggerated carotid baroreflex response. Three types of the syndrome are described: cardioinhibitory, vasodepressor and a mixed form. The gold standard for treatment is insertion of a pacemaker, but this therapy may be effective only in a pure cardioinhibitory type. In contrast, surgically interrupting afferent nerves at the origin may offer relief of symptoms in all three types. The present review analyzes the results of a surgical technique termed "adventitial stripping" of the carotid sinus. Data from 130 procedures demonstrate that carotid denervation is effective in 85% of CSS cases with low complication rates. Postoperative monitoring is mandatory as transient alterations in blood pressure and heart rate may occur.

Publication types

  • Review

MeSH terms

  • Autonomic Denervation / adverse effects
  • Autonomic Denervation / methods*
  • Baroreflex
  • Blood Pressure
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / physiopathology
  • Carotid Artery Diseases / surgery*
  • Carotid Sinus / innervation
  • Carotid Sinus / surgery*
  • Connective Tissue / surgery*
  • Dizziness / etiology
  • Heart Rate
  • Humans
  • Syncope / etiology
  • Syndrome
  • Treatment Outcome