[What are the prerequisites for surgery of asymptomatic carotid stenosis?].
Asymptomatic patients with carotid stenoses exceeding 75% have an elevated ischemic cerebrovascular event rate of 18% per year (5% strokes). Our combined perioperative stroke and death rate (1980-1990: 1123 operations) is 1.85%. Thus prophylactic surgery may be indicated in the following cases: hemodynamically significant stenoses of 75% and more, especially with marginal or reduced autoregulatory reserve, rapidly progressing lesions in medically treated patients, lesions with a high risk of embolization (ulcerations on B-scan), clear interrelation between arterial lesions and positive (asymptomatic) intracranial findings (CT, NMR, TC, USD).
Maurer
P C
PC
Abteilung für Gefässchirurgie, Technische Universität München, Klinikum rechts der Isar.
Dörrler
J
J
von Sommoggy
S
S
Pflugbeil
G
G
D002545:Brain Ischemia / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D003952:Diagnostic Imaging; D004691:Endarterectomy; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality; D015996:Survival Rate