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.
Aungst
M
M
Division of Vascular Surgery, Allegheny University of the Health Sciences, Medical College of Pennsylvania, Hahnemann School of Medicine, Philadelphia, USA.
Gahtan
V
V
Berkowitz
H
H
Roberts
A B
AB
Kerstein
M D
MD
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