title: Carotid endarterectomy without protective measures in patients with occluded and non occluded contralateral carotid artery.
abstract: BACKGROUND
  Comparison of carotid endarterectomy in patients with and without occluded contralateral carotid artery.
  
  
  METHODS
  
  
  
  METHODS
  evaluation of results without using shunt or patch.
  
  
  METHODS
  <<Aretaeion>> Hospital, Medical School, University of Athens.
  
  
  METHODS
  235 patients, divided into group I of 40 patients with and group II of 195 patients without occluded contralateral carotid artery.
  
  
  METHODS
  carotid endarterectomy under general anesthesia.
  
  
  METHODS
  heparin administration, stable hemodynamic status during clamping, short duration monitoring postoperatively.
  
  
  RESULTS
  Postoperative morbidity of both groups was 2.5% (6/235) and mortality 1.7% (4/235). Group I: mortality rate was 2.5% (1/40) major and minor stroke each 2.5% (1/40) and group I: 1.5% (3/195) and 1% (2/195) respectively (NS). Four to 108 months later, 30% (12/40) of group I and 21% (41/195) of group II died.
  
  
  CONCLUSIONS
  Endarterectomy of the carotid artery under general anesthesia without use of shunt and patch in patients with or without occlusion of the contralateral carotid artery presented the same comparative results. Candidates for carotid endarterectomy should be screened systematically for coronary disease preoperatively and annual stress testing postoperatively, tactics which may improve early and late mortality rate after carotid surgery.
authors.affiliation: Department of Vascular Surgery, 2nd Surgical Clinic, University of Athens, Greece.
authors.forename: P B
authors.initials: PB
authors.lastname: Dimakakos
authors.forename: A
authors.initials: A
authors.lastname: Antoniou
authors.forename: M
authors.initials: M
authors.lastname: Papasava
authors.forename: D
authors.initials: D
authors.lastname: Mourikis
authors.forename: D
authors.initials: D
authors.lastname: Rizos
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D001921:Brain / Q000098:blood supply*; D002545:Brain Ischemia / Q000401:mortality / Q000601:surgery*; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D020521:Stroke / Q000401:mortality; D015996:Survival Rate