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Background: Carotid endarterectomy is a recognized method for preventing stroke for both symptomatic and asymptomatic hemodynamically carotid artery stenosis. Hemodynamic depression is more frequently associated with carotid artery stenting, while postoperative hypertension and cerebral hyperperfusion syndrome are known frequent complications after carotid endarterectomy. Severe hypotension after carotid revascularization is associated with a higher risk of perioperative stroke, myocardial infarction, and death, with limited data existing regarding risk factors. This study aims to investigate intraoperative risk factors for severe hypotension after carotid endarterectomy., Methods: A total of 160 patients who underwent carotid endarterectomy were included in this study. Patients with other cardiac conditions that required concomitant cardiac surgery, patients with incomplete medical records, and patients considered high risk for surgery were excluded., Results: The incidence of severe hypotension was 30.6%. Patients with severe hypotension after carotid endarterectomy had a higher incidence of diabetes, moderate mitral valve regurgitation, a history of percutaneous coronary intervention, and higher operative times. Using logistic regression, temporary shunt insertion was independently associated with severe postoperative hypotension (OR = 2.26, 95% CI = 1.09-4.71, p = 0.029)., Conclusions: This result favors the selective shunting strategy when performing carotid endarterectomies, especially for those patients with comorbidities predisposing to postoperative complications.

Primary treatment of most oromaxillofacial tumors in dogs and cats is resective surgery. Management of malignant tumors may be very challenging as wide/radical free-margin surgical removal must be achieved while preserving vital functions. Removal of orofacial tumors may result in large defects exposing the oral cavity or creating a communication with the nasal, pharyngeal, or orbital cavities. Such defects require orofacial reconstruction in order to restore respiratory and manducatory functions. The veterinary surgeon must be familiar with reconstructive techniques in order to prevent the inability of closing the defect, which could lead to an insufficient resection. Small oral defects exposing the nasal cavity are best closed with local random mucosal flaps. Closure of large oral defects may be better achieved with a facial or major palatine-based axial-pattern flap. Small to moderate facial defects can be closed with local advancement or transposition skin flaps. Reconstruction of large facial defects often requires the use of locoregional axial pattern flaps such as the caudal auricular, the superficial temporal, or the facial (angularis oris) myocutaneous axial pattern flaps. Recent publications have shown that the facial (angularis oris) flap is a very versatile and reliable flap in orofacial reconstructive surgery. A surgical decision algorithm based on the size, nature, and location of the defect is proposed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Guzu, Rossetti and Hennet.)

Objective: To report the outcome of mandibular body fractures treated with a wire-reinforced interdental composite splint (WRICS) in small breed dogs., Study Design: Retrospective case series., Animals: Client-owned small breed dogs (n = 24)., Methods: Medical records (1998-2012) of small breed dogs (<10 kg) with mandibular body fractures treated by WRICS were reviewed for signalment, history, type of fracture, treatment, and clinical and radiological follow-up. The angle of the fracture line (ANG) was measured on dental radiographs. A mandibular injury severity score (MISS) and a dental injury score (DIS) were evaluated as potential prognostic factors., Results: Fractures most commonly involved P4-M1 (56%), and healed in a mean time of 2.37 ± 0.7 months. Healing was slower (P = .012) if teeth were present in the fracture line and required extraction, hemisection, or root canal therapy prior to WRICS placement (2.39 ± 0.7 months) than if no dental treatment was required (1.46 ± 0.8 months). Contrary to the MISS, the DIS was associated with longer time to bone healing (P = .001; r = .63) and risk of complications (P = .004). Bone healing time was decreased (P = .003; r = .61) with increasing fracture angles., Conclusion: WRICS can be considered to treat mandibular body fractures in small breed dogs if the fracture is not severely comminuted, and if at least the canine and first molar tooth can be used for anchorage. More severe lesions, such as those with teeth in the fracture line and a shorter fracture surface, are associated with prolonged bone healing., (© 2017 The American College of Veterinary Surgeons.)