Late results of surgical and nonoperative treatment of carotid stenosis. Eighty-four patients documented by angiography in 1974-1976.
The long-term results of carotid endarterectomy are controversial. Here we report the late results of 44 surgically and 40 non-surgically treated patients with carotid stenosis documented by angiography in 1974-1976. The groups were similar with respect to sex-distribution, age, length of follow-up time (median 123.0 and 130.0 months in the surgical and non-surgical groups, respectively) and the occurrence of risk factors. Hypertension was more frequent (p less than 0.05) in the surgical group, as was medical treatment, mostly anticoagulants (p less than 0.06). The angiographic findings were also more severe in this group (p less than 0.001). During the follow-up period the occurrence of cerebrovascular complications (death, stroke and/or TIA) was more frequent in the nonoperated than in the operated group; however, survival of the patients was similar, as the cardiovascular deaths were an equalizing factor. The quality of life in patients alive examined for clinical and neurologic status and by neuropsychological tests and interview was similar, except that the operated patients were more satisfied. The progression of atherosclerosis in the carotid artery assessed by Duplex scanning was more frequent in the nonoperated group. Differences in medical treatment did not explain the results. Thus it is concluded that the late results were better in the operated patients with carotid stenosis than in the nonoperated ones.
Salenius
J P
JP
Department of Surgery and Clinical Sciences, University of Tampere, Finland.
Harju
E
E
Kuukasjärvi
P
P
Haapanen
A
A
Riekkinen
H
H
D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000628:therapy*; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors