Indications for contralateral carotid endarterectomy: role of the noninvasive laboratory.
In 1,733 patients, 2,054 carotid phonoangiographic and oculoplethysmographic studies were performed. Seventy of these patients required carotid endarterectomy either for symptoms or for severely ulcerated plaques. Of these, 12 had bilateral procedures. This review suggests that noninvasive studies can be helpful in determining which patients should undergo contralateral carotid endarterectomy and when. The decision to correct the other side was based on generally accepted indications, development of symptoms and the presence of severely ulcerated plaques. In addition, positive results on carotid phonoangiography and oculoplethysmography, whenever they develop, are a strong indication for the contralateral procedure. The stenotic lesion that appears significant on arteriograhy may not be hemodynamically significant on noninvasive studies. These patients may be followed expectantly with serial carotid phonoangiograhic and oculoplethysmographic studies until hemodynamically significant flow delays appear or symptoms develop.
D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000517:prevention & control; D004691:Endarterectomy; D005260:Female; D006801:Humans; D008297:Male; D010991:Plethysmography