Carotid endarterectomy with an occluded contralateral carotid artery.
Five hundred twenty-six patients who underwent carotid endarterectomy were separated by reviewing those 81 (15%) patients with an occluded contralateral carotid artery and those 445 (85%) with nonocclusion. The population characteristics and surgical indications were similar between the occluded and nonoccluded groups. Ipsilateral plus contralateral perioperative stroke occurred during 11 of 445 operations (2.5%) in which the contralateral carotid was patent, and during which no patient was hemorrhagic. Those patients with contralateral artery occlusion had ipsilateral plus contralateral stroke in 4 of 81 cases of (4.9%) (NS). Intracerebral hemorrhage was responsible for two of four strokes after carotid endarterectomy with contralateral occlusion (p = 0.001). Restenosis to greater than 50% by duplex scanning was more rapid in the occluded group with primary closure (no patch) (p = 0.025) and for men (p = 0.025). Although perioperative safety is comparable, patients with contralateral carotid occlusion may have a greater risk of intracranial hemorrhage and a more rapid rate of restenosis in some subgroups.
McCarthy
W J
WJ
Department of Surgery, Northwestern University Medical School, Chicago, Illinois.
Wang
R
R
Pearce
W H
WH
Flinn
W R
WR
Yao
J S
JS
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery; D002561:Cerebrovascular Disorders / Q000209:etiology; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications