Carotid artery disease and low cerebral perfusion pressure: symptomatology, operative risk and outcome.
Direct internal carotid artery blood pressure measurements in patients undergoing carotid endarterectomy identified 49 patients, among 239 consecutive cases (21%), who had a reduction in perfusion pressure of 20% or more. The clinical history, objective findings and angiographic data were compared with those of a control group of a further 49 patients selected from the remaining patients operated on over the same period. The two groups were compared for short- and long-term outcome of surgery. We were unable to delineate a symptomatic neurological profile that identified patients with low perfusion pressures. Surgery in patients with low perfusion pressures seemed to be associated with an increased complication rate (12% versus 4%), although this was not statistically significant. Definite postoperative improvements in persisting neurological deficits were observed only in one patient. Long-term results were equal in the two groups with an annual stroke risk of 3%.
Schroeder
T
T
Department of Vascular Surgery, Rigshospitalet, University Hospital, Copenhagen, Denmark.
Utzon
N P
NP
Aabech
J
J
Sillesen
H
H
Sørensen
P S
PS
Engell
H C
HC
D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000209:etiology; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk