Carotid endarterectomy outcome is not affected in patients with a contralateral carotid artery occlusion.
BACKGROUND
The purpose of this retrospective patient/control patient study was to determine perioperative risk and long-term benefits of carotid endarterectomy contralateral to an occluded internal carotid artery.


METHODS
Thirty-seven patients undergoing carotid endarterectomy contralateral to an occluded internal carotid artery were each paired with two control group patients (n = 74) undergoing carotid endarterectomy contralateral to a patent internal carotid artery. Patients preferentially underwent electroencephalographic monitoring, selective shunting, and patch angioplasty for vessel closure.


RESULTS
The perioperative rate of stroke or death was 5% (n = 2) in the occluded group and 3% (n = 2) in the control group. Ninety-two percent of the occluded group and 96% of the control patients were stroke-free over a mean follow-up of 23.8 and 27.2 months, respectively. No statistical difference was noted between groups for perioperative rate of stroke or death (P = 0.60), mean stroke-free rates (P = 0.37), stroke rate by life-table analysis (P = 0.33), or survival by life-table analysis (P = 0.43).


CONCLUSIONS
Patients who have carotid endarterectomy performed contralateral to an occluded internal carotid artery showed no difference for perioperative stroke or death, late stroke, or survival.
Division of Vascular Surgery, Allegheny University of the Health Sciences, Medical College of Pennsylvania, Hahnemann School of Medicine, Philadelphia, USA.
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M
Aungst
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Gahtan
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H
Berkowitz
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Roberts
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Kerstein
D000368:Aged; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000401:mortality; D004569:Electroencephalography; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008297:Male; D016343:Monitoring, Intraoperative; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome