Contralateral internal carotid artery occlusion impairs early but not 30-day stroke rate following carotid endarterectomy.
Neurological complications and mortality within 30 days following carotid endarterectomy (CEA) alone or with concomitant cardiac surgery/cardiopulmonary bypass (CPB) were assessed in patients with or without contralateral occlusion of the internal carotid artery (CO-ICA).Of 335 patients undergoing CEA, 173 underwent concomitant cardiac surgery with CPB. Group A consisted of 260 patients without CO-ICA and group B of 75 patients with CO-ICA. The neurological complications (peripheral nerve damage, transient ischemic attack [TIA], prolonged reversible ischemic neurological deficit [PRIND], and stroke) and the Rankin index within 24 hours and 30 days postoperatively were compared. Strokes within 24 hours were significantly increased (P = .006) in group B (11%) compared with A (3.1%); TIA and PRIND did not differ (P = .33). The overall neurological complications and in particular for peripheral neurological damage, TIA/PRIND, and stroke did not differ within the 30-day-period postsurgery. A significantly higher stroke rate within 24 hours postsurgery occurred in patients with CO-ICA.
Bagaev
Erik
E
Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. bagaev.erik@mh-hannover.de
Pichlmaier
A Maximilian
AM
Bisdas
Theodosios
T
Wilhelmi
Mathias H
MH
Haverich
Axel
A
Teebken
Omke E
OE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002340:Carotid Artery Diseases / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D002343:Carotid Artery, Internal; D015897:Comorbidity; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D013997:Time Factors