[Natural course of the carotid artery contralateral to carotid endarterectomy in Japan].
There are few studies that describe long-term outcome of the carotid artery contralateral to carotid endarterectomy (CEA) in Japan. This study, therefore, was aimed at assessing the incidence and clinical features of patients whose contralateral carotid artery showed progression to significant stenosis (more than 70%). This study included 130 patients who underwent CEA for internal carotid artery stenosis between 1998 and 2007. During follow-up periods of a mean of 34.3 months, MR angiography or 3-dimenional CT angiography was performed every 6 or 12 months. Risk factors including hypertension, diabetes mellitus, hyperlipidemia, and coronary artery disease were also evaluated to clarify the significant predictors for disease progression of the carotid artery contralateral to CEA. The results were that, the carotid artery contralateral to CEA showed disease progression to significant stenosis (> 70%) in 12 of 130 patients (9.2%). The interval between CEA and disease progression of the carotid artery contralateral to CEA ranged from 13 to 103 months (mean, 50.7 months). Of these 9 patients underwent CEA for contralateral carotid artery stenosis to prevent ischemic stroke. Multiple logistic regression analysis revealed that there were no predictors for disease progression of the carotid artery contralateral to CEA during follow-up periods. This is the first report that has analyzed the incidence and clinical features of disease progression of the carotid artery contralateral to CEA in Japan. Its incidence is not low in Japan, and careful long-term follow-up would be essential to prevent additional stroke occurrence in patients who undergo CEA.
Iwasaki
Motoyuki
M
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.
Kuroda
Satoshi
S
Yasuda
Hiroshi
H
Nakayama
Naoki
N
Saito
Hisatoshi
H
Iwasaki
Yoshinobu
Y
D000368:Aged; D000792:Angiography; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D018450:Disease Progression; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D014057:Tomography, X-Ray Computed