[Carotid endarterectomy in chronic renal failure patients: report of two cases].
Chronic renal failure is one of the risk factors for carotid atherosclerosis. We report two cases of stenosis of the carotid bifurcation treated by carotid endarterectomy. A 66-year-old man with a 17-year history of hemodialysis experienced repeated episodes of right hemiparesis. Cerebral angiography showed severe stenosis of the cervical carotid bifurcation bilaterally. Left and right carotid endarterectomy operations were performed one month apart. The postoperative course was uneventful, and the patient returned home without neurological symptoms. The second case was in a 49-year-old woman with a 15-year history of hemodialysis had vertigo of one month duration. Cerebral angiography revealed occlusion of the left subclavian artery, and the distal left axillary artery was filled by retrograde flow from the left vertebral artery. Stenosis of the right carotid bifurcation was also noted. Right carotid endarterectomy was performed without any complications. Although a high incidence of intraoperative complications and of recurrent stroke after carotid endarterectomy (CEA) has been reported in chronic renal failure patients, the poor prognosis of the natural history of severe carotid stenosis in chronic renal failure should be taken into consideration. The cases reported indicate that carotid endarterectomy is safe and justified for carotid stenosis in chronic renal failure patients.
Department of Neurosurgery, Hanwa Memorial Hospital, 7-11-11, Karita, Sumiyoshi-ku, Osaka-city, Osaka 558-0011, Japan.
Katsumi
K
Matsumoto
Katsuhito
K
Akagi
Makoto
M
Abekura
Tateo
T
Sakaguchi
Takahiro
T
Tomishima
Masayuki
M
Hirata
Masayuki
M
Aoki
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000601:surgery*; D001161:Arteriosclerosis / Q000209:etiology* / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000209:etiology* / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D016896:Treatment Outcome