title: Internal carotid artery surgery: ten-year results.
abstract: The twofold purpose of this study was to compare the immediate results of surgery for lesions of the internal carotid artery in two series of patients operated on at 10-year intervals and to assess long-term results in the earliest series. Series I comprised 242 reconstructions in 220 patients (160 men and 60 women, mean age 64.4 years) performed between 1980 and 1982. Seventy patients (35%) were asymptomatic, 113 had monocular or hemispheric symptoms, and 30 had nonhemispheric symptoms. Contrast arteriograms revealed internal carotid artery stenosis of < 30% in 74 cases (30.6%), between 30% and 70% in 49 (20.2%), and > 70% in 119 (49.2%). Reconstruction was achieved by endarterectomy in 164 cases (67.8%), by vein graft in 75 cases (31%), and by other methods in 3 cases (1.2%). Postoperative mortality was 5% (11/110). Nonfatal postoperative stroke occurred in 1.8% (4/220) and transient ischemic attack in 0.5% (1 patient). All reconstructions were patent on postoperative control. The combined mortality/morbidity rate in patients in series II operated on between 1990 and 1991 was significantly lower, that is, 2.4% (4/170) vs. 6.8% (15/220) (p < 0.05). In series I, 11 patients (5%) were lost to follow-up and 124 were still alive at the beginning of the tenth postoperative year. Cumulative survival was 79 +/- 5.6% at 5 years and 60.9 +/- 6.7% at 10 years. The causes of late death were stroke in 7 cases, cardiovascular disease in 30 cases, cancer in 16 cases, and other causes in 20 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Sainte-Marguerite, Marseille, France.
authors.forename: P E
authors.initials: PE
authors.lastname: Magnan
authors.forename: T
authors.initials: T
authors.lastname: Caus
authors.forename: A
authors.initials: A
authors.lastname: Branchereau
authors.forename: E
authors.initials: E
authors.lastname: Rosset
authors.forename: F
authors.initials: F
authors.lastname: Prima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002340:Carotid Artery Diseases / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000401:mortality / Q000517:prevention & control; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014680:Veins / Q000637:transplantation