Surgical management of atheroslerotic internal carotid artery stenosis — first own experience report from General and Vascular Surgery Ward in Siedlce Specialist Hospital

Abstract

Introduction: During the period 2009–2011 we performed 163 cervical endarterectomies in the General and Vascular Surgery Ward in Siedlce Specialist Hospital.

Material and methods: 144 patients (89%) underwent CEA because of symptomatic ICA stenosis of more than 70%. Moreover, the remaining 19 patients (11%) had asymptomatic ICA stenosis of more than 80%. A shunt was employed generally in 9 patients.

Results: CEA was performed with artery primary closure in 142 (87%) and in 21 (13%) cases using a polyu­rethane patch. Total percentage of strokes and deaths was 1.3%. In 3 cases (1.8%) there was no reverse ICA blood flow and a preoperative ultrasound examination did not show ICA occlusion.

Conclusions: 1. Introducing new cervical artery revascularization centers do not negatively affect nationwide postoperative complication rates. 2. Patients with critical internal cervical artery stenosis should undergo a Doppler-duplex ultrasound examination before an endarteriectomy. 3. The use of a polyurethane patch to perform an arteriotomy closure reduces the risk of restenosis.