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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Carotid endarterectomy in patients with occlusion of the contralateral carotid artery. Perioperative risk and late results

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Vis graf over relationer

Recent reports on the outcome of carotid endarterectomy in patients with contralateral occlusion have been conflicting. Therefore, we reviewed 51 cases identified, among 675 consecutive carotid endarterectomies. A perioperative mortality of 2% and a permanent morbidity rate of 16% was observed. Compared with a complication rate of about 5% previously reported from this institution, this clearly indicates contralateral carotid occlusion as a major risk factor in carotid surgery. Though not statistically significant, patients with severely reduced cerebral perfusion pressure (CPP) had suffered more severe strokes when compared to patients with only minor reduction in CPP. In addition, the internal carotid artery blood flow following endarterectomy was significantly higher in the low pressure group (P less than 0.02). No patients were lost during follow-up, for a mean of 34 months. The cumulative five-year survival rate was 74%, not significantly different from the expected survival of an age and sex matched population. During the period of follow-up 16 patients experienced new neurologic symptoms, in six (2 strokes and 4 TIA's) referable to the hemisphere ipsilateral to operation and in 10 (2 strokes and 8 TIA's) referable to the contralateral hemisphere. The five-year stroke rate was 16%. This together with the observed survival rate indicated a better-than-expected course in this group of patients with severe cerebrovascular atherosclerosis.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Vascular and Endovascular Surgery
Vol/bind1
Udgave nummer2
Sider (fra-til)85-9
Antal sider5
ISSN0950-821X
StatusUdgivet - apr. 1987

ID: 46028082