title: Stroke risk reduction in asymptomatic and symptomatic patients treated surgically: the effectiveness of carotid endarterectomy with patch graft angioplasty.
abstract: From March 1980 to March 1987, 217 consecutive patients underwent 252 carotid revascularisations with routine use of continuous EEG monitoring and selective use of an intraluminal shunt for symptomatic (70%) or asymptomatic (30%) internal carotid artery (ICA) atherosclerotic stenosis. All carotid endarterectomies were routinely performed with a patch graft angioplasty. None of the patients suffered permanent or transient neurological deficits in the immediate postoperative period and none of them died. There was an 0.8% stroke rate and 0.4% mortality rate in the early postoperative course. Neurological assessment, Doppler and Echo doppler sonography of both the operated and the contralateral ICA was performed every 6 months. One-hundred and twenty-one patients (142 carotid revascularisations) operated on up to December 31st 1985 were reassessed in July 1986. The mean follow-up time was 35 months (range: 6 months to 6 years). New neurological symptoms were present in 7.4% of the patients; 2.5% of patients developed a stroke and 8.9% showed progression of stenosis in the contralateral ICA. One patient had a common carotid artery stenosis 2 years after surgery. Re-stenosis of the ICA was found in two patients who underwent re-operation without difficulty. The late mortality was 21.4% (11.9% of the overall series). In only two patients (7.6%) was stroke the cause of death.
authors.affiliation: Department of Vascular Surgery, University of Padua, School of Medicine, Italy.
authors.forename: G P
authors.initials: GP
authors.lastname: Deriu
authors.forename: E
authors.initials: E
authors.lastname: Ballotta
authors.forename: E
authors.initials: E
authors.lastname: Facco
authors.forename: L
authors.initials: L
authors.lastname: Franceschi
authors.forename: S
authors.initials: S
authors.lastname: Alvino
authors.forename: A
authors.initials: A
authors.lastname: Saia
authors.forename: A
authors.initials: A
authors.lastname: Calabrò
authors.forename: F
authors.initials: F
authors.lastname: Grego
authors.forename: L
authors.initials: L
authors.lastname: Bonavina
mesh_terms: D001807:Blood Vessel Prosthesis; D002339:Carotid Arteries / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000517:prevention & control*; D004569:Electroencephalography; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors