Question

A.) List the specific pack and special sterile supplies you will need to complete the endarterectomy. B.) Include the medications on your field, their classifications, and what they are used for, C.) include the specific instrument set you will need, D.) explain how the Javid clamp and shunt function during this procedure?

Answer 1

B)Antiplatelet drugs-Aspirin,Statins and beta blockers

An antiplatelet drug (antiaggregant), also known as a platelet agglutination inhibitor or platelet aggregation inhibitor, is a member of a class of pharmaceuticals that decrease platelet aggregation and inhibit thrombus formation. They are effective in the arterial circulation, where anticoagulants have little effect.

Statins are a type of medication that blocks the action of a liver enzyme that helps produce cholesterol. They are typically prescribed to lower blood cholesterol levels.

Beta blockers (beta-blockers, β-blockers, etc.) are a class of medications that are predominantly used to manage abnormal heart rhythms, and to protect the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention).

C)Equipment used for carotid bypass and reconstruction includes the following:

• Surgical loupes (×2.5, ×3.5)

• Fine vascular clamps and instruments (ie, a cervical carotid endarterectomy [CEA] set), including detachable occluding clips (eg, Heifetz or Yasargil)

• Short occluding balloons if the vessel is not amenable to clamping

• Arterial shunts (eg, Javid or Sundt)

• Polytetrafluoroethylene (PTFE) or other prosthetic grafts of appropriate length and caliber – Commonly, 6-mm grafts are used for the internal carotid artery (ICA) and 8-mm grafts for the common carotid artery (CCA)

• Sternotomy set

• Doppler ultrasonography (US) device for intraoperative assessment of blood flow

• D)Javid Clamps used to hold the Javid Shunt in place during the endarterectomy.The use of a shunt, as a transient skip can minimize the length of time that blood glide to the talent is interrupted during the operation. This may additionally minimize the threat of perioperative stroke however may want to additionally result in arterial wall injury and therefore extend the danger of stroke .The Javid shunt could no longer be used in only four of the 193 operations in which its insertion was once attempted. It induced arterial harm in only one patient. The outcomes advocate that the routine use of the shunt was of cost and that carotid endarterectomy can be a safe, pretty complication-free, method.