Long-term results after carotid artery surgery.
This study presents the results from a follow-up after 414 carotid reconstructions performed on 352 patients during the years 1971-82. At the end of the follow-up period 267 patients were alive (75.8%) and 253 patients remained asymptomatic. The median follow-up time was 35 months (6 months-12 years). Patients with coronary artery disease (CAD) had a significantly lower survival than patients without signs of CAD. Coronary artery disease was significantly more frequent among patients with bilateral carotid lesions compared to patients with unilateral lesions. The actuarial stroke frequency, operative morbidity included, on the operated side was 2.5%/year. However, from 6 months postoperatively up to 8 years the stroke frequency was 1%/year. In the stroke frequencies all neurological deficits of more than 24 h duration are accounted for. Although there was a trend toward higher stroke rates among older patients there were no significant differences between age groups. Assuming a 10% stroke frequency during the first year after a TIA and a 6% annual stroke rate thereafter our results would cross even such a natural course curve at 18 months.
Forssell
C
C
Department of Surgery, University of Lund, Malmö General Hospital, Sweden.
Takolander
R
R
Bergqvist
D
D
Bergentz
S E
SE
Olivecrona
H
H
D000206:Actuarial Analysis; D002339:Carotid Arteries / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000401:mortality / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000517:prevention & control*; D003327:Coronary Disease / Q000401:mortality; D004691:Endarterectomy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors