[Neurologic complication of carotid thrombendarterectomy].
OBJECTIVE
Carotid endarterectomy (CEA) is often carried out to prevent cerebrovascular strokes. It is obviously important that neurological morbidity of the procedure is contained within acceptable limits (< 2%).


METHODS
Between January 1991 and December 1997 a total of 239 CEA were performed in 216 patients (169 males and 47 females, mean age 66.6 +/- 14.2 years; range 43-81). Angioplasty was carried out using a precoagulated Dacron patch, except in cases in which the residual diameter of the internal carotid artery was greater than 5 mm. A Javid shunt was used selectively if stump pressure < 50 mmHg.


RESULTS
No major neurological complications were observed. A reversible focal neurological deficit was reported in 3 cases (1.2%). Neurological morbidity correlated to peripheral arterial occlusive disease appears to be correlated mainly with technical reasons or cerebral ischemia following clamping.


CONCLUSIONS
The extensive use of angioplasty with patch and the selective use of a protective shunt improve the technical success rate of surgery, significantly helping to limit morbidity.
Aurelia Hospital, Roma.
M
M
Garofalo
R
R
Borioni
P
P
Albano
P
P
Nardi
L
L
Colagrande
F
F
Seddio
A
A
Scafuri
L
L
Chiariello
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods; D002341:Carotid Artery Thrombosis / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000517:prevention & control; D004691:Endarterectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors
Complicanze neurologiche nella tromboendoarteriectomia carotidea.