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Surgical management of atheroslerotic internal carotid artery stenosis — first own experience report from General and Vascular Surgery Ward in Siedlce Specialist Hospital
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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.
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.
Keywords
ischemic stroke, internal carotid artery, carotid endarterectomy
About this articleTitle
Surgical management of atheroslerotic internal carotid artery stenosis — first own experience report from General and Vascular Surgery Ward in Siedlce Specialist Hospital
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
19-24
Published online
2014-01-08
Page views
846
Article views/downloads
3083
Bibliographic record
Chirurgia Polska 2013;15(1):19-24.
Keywords
ischemic stroke
internal carotid artery
carotid endarterectomy
Authors
Stanisław Jeziernicki
Henryk Komoń
Stanisław Mazur
Paweł Ziękiewicz
Krzysztof Kicki
