Simultaneous bilateral carotid endarterectomy: our first experience.
Indications for and against bilateral carotid surgery as a simultaneous or a staged procedure and patient selection criteria for simultaneous bilateral carotid endarterectomies (SBCE) are discussed.


METHODS
Six patients who underwent 12 SBCE (group A) were compared with 20 patients who underwent 40 bilateral staged endarterectomies (group B). The indications and surgical management were similar and the accompanying risk factors were comparable in both groups. A shunt or patch was not used and the occlusion time was 12.5+/-2'. Total occlusion time in the SBCE was 25+/-2.5'.


RESULTS
The results are comparable in both groups. In the SBCE group no major neurological complications were noted except for a transient hypoglossal paresis. In group B a case with transient ischemic attack (TIA) was noted; however no mortality, myocardial infarct, respiratory problems or permanent damage of the central nerves were observed in either groups.


CONCLUSIONS
Although our number of patients was not satisfactory to yield a conclusion, our results, together with that of the international literature were encouraging for SBCE. SBCE can be safely performed, in experienced hands with a better preoperative assessment of the function of the circle of Willis in association with meticulous surgical technique and proper patient selection.
Farsak
B
B
Department of Thoracic and Cardiovascular Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Oç
M
M
Boke
E
E
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D016893:Carotid Stenosis / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
D000959:Antihypertensive Agents