[Does multi-vessel disease of brain supplying arteries modify the procedure in carotid operations?].
In a prospective evaluation 159 patients with carotid artery stenosis showed a multiple artery disease in 78 to 99% depending on the grade of cerebral artery insufficiency. Contralateral occlusion process could be detected in 15.7%, internal and common carotid artery occlusion in 16 patients (10%). 1595 patients picked out of the literature have been analyzed in respect of the natural history which showed a risk to develop a stroke in 4.5%/year. In further 1286 operated patients of other reports the morbidity and mortality rate ranged 4.5% and the risk of further neurologic events after operation was 2.4%/year. The use of an intraluminal shunt after thrombendarterectomy proved to be a good procedure to lower the morbidity and mortality rate without any intraoperative monitoring.
Kogel
H
H
Abteilung Chirurgie, Dreifaltigkeits-Hospital Lippstadt.
D001807:Blood Vessel Prosthesis; D001921:Brain / Q000098:blood supply*; D002545:Brain Ischemia / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery*; D004292:Dominance, Cerebral / Q000502:physiology; D016894:Endarterectomy, Carotid; D006801:Humans; D016343:Monitoring, Intraoperative; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000503:physiopathology; D011446:Prospective Studies; D016896:Treatment Outcome
Nimmt die Mehrgefässerkrankung der hirnversorgenden Arterien Einfluss auf das Vorgehen bei Carotisoperationen?