Medistim’s systems offer the unique combination of flow measurement (TTFM) and high frequency ultrasound imaging guidance to help reduce and minimize the risk of postoperative neurological issues.
Vascular surgeons should use Medistim systems for quality assurance during carotid endarterectomy (CEA) to get immediate feedback on their work. When technical defects go undetected, patients are at risk of postoperative stroke. Medistim technology gives surgeons the opportunity to revise on the spot.
The use of ultrasound imaging as a quality assessment tool has proven effective in revealing technical imperfections in > 10% of cases, leading to immediate revision.
Ultrasound imaging is a valuable tool for visualization and evaluation of the stenosis and the completed endarterectomy. An image of the anastomosis reveals otherwise unseen imperfections and gives the surgeon the chance to correct before closure. Graft patency is the predominant predictor of early neurological events.
Carotid Endarterectomy (CEA)
2023 ESVS Guidelines
"For patients undergoing carotid endarterectomy, intra-operative completion imaging with
angiography, duplex ultrasound or angioscopy should be considered in order to reduce the risk
of peri-operative stroke."
Class Ila, Level B
Naylor A, Rantner B, Ancetti S, de Borst G, De Carlo M, Halliday A, Kakkos S, Markus H, McCabe D, Sillesen H, van den Berg J, Vega de Ceniga M, Venermo M, Vermassen F, Antoniou G, Bastos Goncalves F, Björck M, Chakfe N, Coscas R, Dias N, Dick F, Hinchliffe R, Kolh P, Koncar I, Lindholt J, Mees B, Resch T, Trimarchi S, Tulamo R, Twine C, Wanhainen A, Bellmunt S, Bulbulia R, Darling 3rd C, Eckstein H, Giannoukas A, Koelemay M, Lindström D, Schermerhorn M, Stone D, 2022
European society for vascular surgery (ESVS) 2023 clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease
Knappich, C., Lang, T., Tsantilas, P., Schmid, S., Kallmayer, M., Haller, B., and Eckstein, H. H., 2022
Intraoperative completion studies in carotid endarterectomy: systematic review and meta-analysis of techniques and outcomes
Knappich, C., Kuehnl, A., Tsantilas, P., Schmid, S., Breitkreuz, T., Kallmayer, M., Zimmermann, A. and Eckstein, H. H. (2017), Stroke:
Intraoperative Completion Studies, Local Anesthesia, and Antiplatelet Medication are Associated with Lower Risk in Carotid Endarterectomy