Carotid endarterectomy for asymptomatic carotid artery stenosis

patients with severe bilateral disease a high risk subgroup

Michael Appleberg*, David Cottier, John Crozier, John Graham, Rodney Lane

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Carotid endarterectomy if advised for asymptomatic disease must be associated with a low peri‐operative morbidity and mortality and satisfactory long‐term results. Over a 12 year period between 1978–1989 181 carotid endarterectomies were performed on 163 patients with asymptomatic carotid artery stenosis. There were 112 males and 51 females with a mean age of 64.9 years. All patients had a high‐grade lesion (> 70% stenosis). The combined operative mortality and stroke rate was 2.8%. On long‐term follow up six patients suffered a stroke. Only one patient however sustained a stroke in the same territory as the previously operated carotid artery. Four years following surgery 78% of patients were alive. Carotid restenosis or occlusion occurred in 8.3% of the remaining patients, all of whom were asymptomatic. All the immediate postoperative strokes occurred in patients with severe bilateral carotid artery disease. These patients with severe bilateral disease appear to constitute a high risk sub‐group for peri‐operative stroke. The role of ‘normal pressure‐hyperperfusion breakthrough’ syndrome as the presumed aetiology of two of the postoperative cerebral haemorrhages is discussed.

Original languageEnglish
Pages (from-to)160-165
Number of pages6
JournalAustralian and New Zealand Journal of Surgery
Volume65
Issue number3
DOIs
Publication statusPublished - 1995
Externally publishedYes

Keywords

  • asymptomatic patients
  • carotid endarterectomy
  • risks of surgery.

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