Abstract:
To evaluate the efficacy of perivascular sympathectomy in managing adventitia layerrelated long-segment tubular stenosis of cervical segment (C1) internal carotid arteries (ICAs) in a cohort where conventional medical and endovascular interventions were not viable options, we retrospectively analyzed 20 patients (8 males, 12 females, aged 41–63 years) who underwent perivascular sympathectomy for long-segment (>5 cm) tubular cervical ICA stenosis (non-atherosclerotic, non-intima related, and nondolichoarteriopathic) between 2017 and 2023. The procedure aimed to alleviate symptoms such as hemiparesis, pulsatile tinnitus, and migraines associated with transient ischemic attacks (TIAs). Preoperative and postoperative symptoms were assessed, and patient follow-up was conducted by MR angiography and perfusion studies. Postoperatively, 10 out of 11 migraine sufferers (90.9%) reported complete cessation of symptoms, while one patient (9.09%) experienced reduction in frequency and intensity. In cases of tinnitus, six out of nine patients (66.6%) reported complete resolution, two (22.2%) had reduced symptoms, and one (11.1%) saw no change. Regarding motor function, all 12 patients (100%) with initial hemiparesis (30–40% loss of motor function) showed complete recovery postoperatively. There was no TIA attack among the patients after the procedure in the mean two-year follow-up. Perivascular sympathectomy has shown promising results in alleviating symptoms and preventing recurrent cerebrovascular events in long-segment tubular stenosis of cervical ICAs.
Biography:
Mehmet Erkan Ustun completed his medical education at Hacettepe University, School of Medicine in 1986. Mehmet Erkan Ustun then pursued his residency training in Neurosurgery at Ankara University, Avicenna Hospital, completing it in 1992. During this period, Mehmet Erkan Ustun had the opportunity to train under renowned experts in vascular and functional neurosurgery, which greatly shaped his professional development. In 2009, Mehmet Erkan Ustun was promoted to the academic rank of Professor in Neurosurgery. Subsequently, Mehmet Erkan Ustun earned a PhD in Anatomy in 2011, further deepening his understanding of neuroanatomical structures and functions. Today, in addition to performing standard neurosurgical procedures, Mehmet Erkan Ustun specialize in vascular and functional neurosurgical operations. These procedures aim to restore lost or impaired neurological functions, often providing signifi cant improvements in patients' quality of life. Mehmet Erkan Ustun have over 1500 citations in journals listed in SCI (Science Citation Index) or SCI-Expanded. Using new techniques in the treatment of carotid and vertebrobasilar insufficiency, Mehmet Erkan Ustun operated on more than 200 patients (83 with carotid and 122 with vertebrobasilar insufficiency). We have identifi ed a novel etiopathogenetic factor in carotid insufficiency, which has been published in the journal Brain Sciences.
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