Risk of early controlateral carotid endarterectomy.
Between January 1984 and January 1994, we performed early endarterectomy of the controlateral carotid on 94 patients within a delay of 1 to 8 days after the first endarterectomy. Lesions were symptomatic in 58 patients (62%) and asymptomatic in 36 patients (38%). Eighty-four operations were performed under cervical block anesthesia (89%), eight under general anesthesia, and two under local anesthesia (2%). Severe intraoperative hypertension occurred in seven patients (7%) including five under cervical block anesthesia (6%) and two under general anesthesia (25%). Two patients (2.1%) died of stroke secondary to carotid thrombosis in one case and hyperperfusion syndrome in one case. Morbidity included one transient ischemic attack (1%) and one myocardial infarction (1%). Postoperative control of patency revealed asymptomatic occlusion of the internal carotid artery in two patients, accounting for one of the two deaths. Our findings demonstrate that neurologic mortality/morbidity is not higher after early controlateral carotid endarterectomy than unilateral endarterectomy.
Habozit
B
B
Clinique Générale de Savoie, Chambery, France.
Derosier
J P
JP
Gaillard
A
A
D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000601:surgery; D002340:Carotid Artery Diseases / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors