| Title |
Endarterektomijos rizika esant didelio laipsnio vidinės miego arterijos stenozei ir priešingos pusės vidinės miego arterijos užakimui / |
| Translation of Title |
Risk of carotid endarterectomy in patients with severe carotid artery stenosis and contralateral carotid artery occlusion. |
| Authors |
Meškauskienė, Auksė ; Barkauskas, Egidijus Vytautas ; Mackevičius, Artūras ; Bičkuvienė, Ilona ; Gaigalaitė, Virginija |
| DOI |
10.15388/LietChirur.2006.3.2265 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2006, t. 4, Nr. 3, p. 208-213.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
carotid endarterectomy ; occlusion of contralateral carotid artery ; operative complications |
| Abstract [eng] |
Background/objective: Most of the current literature supports carotid endarterectomy for patients suffering from severe carotid stenosis and contralateral carotid artery occlusion. During carotid endarterectomy of patients with contralateral internal carotid artery occlusion, changes of brain circulation and cerebral perfusion may lead to the development of neurological symptoms and the higher rates of complications.The aim of our study was to assess carotid endarterectomy in patients with contralateral carotid artery occlusion in comparison to those without contralateral occlusion with regard to the preoperative neurological status, shunt use and perioperative complication rates. Patients and methods During 1995–2004, we studied the preoperative, intraoperative findings and results of carotid endarterectomy in two groups: I – patients with stenosis and contralateral occlusion (n = 102) and II – patients with stenosis and no contralateral occlusion (n = 542). Both groups were divided into symptomatic (S) and asymptomatic (B) patients. Results: The demographic and clinical characteristics were similar for both groups. Shunt insertion was required in 72% of group I and in 59% of group II (p < 0.001). The rate of perioperative stroke and mortality was 7.8% for group I and 4.6% for group II (p = 0.62). The rate of intracerebral hemorrhage was 3.9% in group I and 05% in group II (p < 0.05). The perioperative risk of stroke and death was higher in patients with symptomatic versus aymptomatic occlusion of contralateral carotid artery (9.5% vs 3.4%; p = 0.049).Conclusions: Since patients with contralateral occlusion are at a high risk for brain ischemia during internal carotid artery clamping, they frequently require shunt insertion. Occluded contralateral carotid artery is an important factor for predicting cerebral hemorrhagic caused by carotid endarterectomy. Symptomatic occlusion of the contralateral carotid artery means that the possibility of perioperative neurologic complications is greater. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2006 |
| CC license |
|
