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Carotid endarterectomy in patients with contralateral internal carotid artery occlusion
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Abstract
Material and methods. Four hundred and twenty-two CEA were performed in 390 patients between 1990–1998. Sixty-five (16.7%) patients had contralateral ICA occlusion (group I). The rest, 325 patients (83.3%), had patent contralateral ICA - group II. We operated on mainly severe (> 70%) ICA stenoses (94.8%). The preoperative risk factors were similar in both groups. Preoperative severe stroke on the operated ICA side was significantly more often observed in group I (p = 0.01). Standard CEA with direct arterial suture was performed in all cases.
Results. Preoperative computed tomography (CT) scan revealed more often ischaemic focus on the operated side in group I (p < 0.001). Intraoperative shunt was significantly more often used in patients with contralateral ICA occlusion (p < 0.001). The perioperative stroke from the operated side was observed in 3% patients from group I and in 3.1% from group II. Contralateral stroke occurred in 1.5% from group I, and 0.56% from group II. Mortality rate was respectively 1.5% for group I, and 1.3% for group II (p = NS).
Conclusions. Risk of preoperative stroke and mortality rate were not higher for patients with contralateral ICA occlusion. Intraoperative shunt was significantly more often used in patients with contralateral ICA occlusion.
Abstract
Material and methods. Four hundred and twenty-two CEA were performed in 390 patients between 1990–1998. Sixty-five (16.7%) patients had contralateral ICA occlusion (group I). The rest, 325 patients (83.3%), had patent contralateral ICA - group II. We operated on mainly severe (> 70%) ICA stenoses (94.8%). The preoperative risk factors were similar in both groups. Preoperative severe stroke on the operated ICA side was significantly more often observed in group I (p = 0.01). Standard CEA with direct arterial suture was performed in all cases.
Results. Preoperative computed tomography (CT) scan revealed more often ischaemic focus on the operated side in group I (p < 0.001). Intraoperative shunt was significantly more often used in patients with contralateral ICA occlusion (p < 0.001). The perioperative stroke from the operated side was observed in 3% patients from group I and in 3.1% from group II. Contralateral stroke occurred in 1.5% from group I, and 0.56% from group II. Mortality rate was respectively 1.5% for group I, and 1.3% for group II (p = NS).
Conclusions. Risk of preoperative stroke and mortality rate were not higher for patients with contralateral ICA occlusion. Intraoperative shunt was significantly more often used in patients with contralateral ICA occlusion.
Keywords
internal carotid artery; carotid endarterectomy; internal carotid artery occlusion
About this articleTitle
Carotid endarterectomy in patients with contralateral internal carotid artery occlusion
Journal
Issue
Article type
Research paper
Pages
7-13
Published online
2002-02-07
Page views
1352
Article views/downloads
1711
DOI
10.5603/aa.9961
Bibliographic record
Acta Angiologica 2002;8(1):7-13.
Keywords
internal carotid artery
carotid endarterectomy
internal carotid artery occlusion
Authors
Jerzy Leszczyński
Andrzej Krzysztof Małek
Sadegh Toutounchi
Waldemar Macioch
Mieczysław Szostek