[Internal carotid artery endarterectomy--prospective evaluation].
The aim of this study was to present early and late results of carotid endarterectomy (CEA). We evaluated prospectively 270 CEA performed from 1990 to 1996. More of our patients were men (62%), their age ranged from 28 to 82 years (mean 62.4). Preoperative high grade stenosis (> 70%) of internal carotid artery stenosis was recognized in over 91% of patients according to duplex examination. All operations were performed by the same surgical team with the use of standard CEA without patching. General anaesthesia was used to the middle of 1993. Then all the patients were operated on under regional anaesthesia. Our follow-up consisted of clinical and duplex-scan examination performed regularly from 3 to 72 months after CEA. In the immediate postoperative period (30 days) four patients died (mortality rate 1.5%), mostly due to MI. The long term (72 months) follow-up revealed 12 deaths mostly due to heart attacks or cancer. We observed 11 high grade (> 70%) late recurrent stenoses. There were no deaths due to stroke from the operated artery. Duplex-scan of carotid arteries is a very effective and safe method of preoperative and postoperative evaluation. Regional anaesthesia allows direct estimation of neurological statement during operation. CEA is the only one method of stroke prevention in patients with symptomatic high-grade stenoses.
Toutounchi
S
S
Kliniki Chirurgii Ogólnej i Chorób Klatki Piersiowej Akademii Medycznej w Warszawie.
Małek
A K
AK
Leszczyński
J
J
Elwertowski
M
M
Mieszkowski
J
J
Szostek
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D011446:Prospective Studies; D012008:Recurrence; D015996:Survival Rate; D014463:Ultrasonography