title: Carotid artery disease and low cerebral perfusion pressure: symptomatology, operative risk and outcome.
abstract: 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%.
authors.affiliation: Department of Vascular Surgery, Rigshospitalet, University Hospital, Copenhagen, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Schroeder
authors.forename: N P
authors.initials: NP
authors.lastname: Utzon
authors.forename: J
authors.initials: J
authors.lastname: Aabech
authors.forename: H
authors.initials: H
authors.lastname: Sillesen
authors.forename: P S
authors.initials: PS
authors.lastname: Sørensen
authors.forename: H C
authors.initials: HC
authors.lastname: Engell
mesh_terms: 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