title: Intracranial occlusions and internal carotid artery stenoses: clinical implications.
abstract: BACKGROUND
  The aim of this research was to investigate the influence of intracranial stenoses or occlusions on the outcome of carotid endarterectomy (CEA) in patients with internal carotid artery stenosis. The authors also searched for internal carotid artery plaque's morphology influence on the atherosclerotic process in intracranial arteries.
  
  
  METHODS
  The study included 154 patients who underwent angiography and CEA. Intracranial lesions (stenosis or occlusion) were stated in 28 (18.2%) patients.
  
  
  RESULTS
  Perioperative stroke - death rate was 3.9%. Statistical analysis revealed that perioperative stroke after CEA appeared significantly more often in patients with intracranial stenoses or occlusions (p = 0.0104). Late death-stroke rate was 13.6%. Log-rank test revealed that after a 1-year follow-up period, there were significantly more survivals in patients without intracranial lesions than in those with intracranial lesions (p = 0.048).
  
  
  CONCLUSIONS
  Intracranial stenosis or occlusion predicts poor perioperative neurological outcome. Patients with intracranial lesions benefit less from endarterectomy in a 1-year follow-up period. On the basis of internal carotid artery plaque's morphology, no conclusions on advancement of intracranial arteries' atherosclerosis can be made.
authors.affiliation: Department of Vascular, General and Oncologic Surgery, Memorial Copernicus Hospital, Lodz, Poland. mstelagowski@vp.pl
authors.forename: Mirosław
authors.initials: M
authors.lastname: Stelagowski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bogusiak
authors.forename: Anna
authors.initials: A
authors.lastname: Kasielska
authors.forename: Marek
authors.initials: M
authors.lastname: Łysakowski
authors.forename: Piotr
authors.initials: P
authors.lastname: Kaźmierski
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szostek
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D016009:Chi-Square Distribution; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D011044:Poland; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial