[Diagnosis and surgical treatment of tight carotid stenosis].
OBJECTIVE
To explore the specialty of diagnosis and surgery of tight carotid stenosis.


METHODS
From January 2000 to December 2009, 53 patients with tight carotid stenosis (> 95%) were operated on. All 53 patients had tight carotid stenosis more than 95% on one side in whom 28 had contralateral carotid stenosis or occlusion. The clinical and imaging data as well as surgical outcomes of the patients were retrospectively analyzed.


RESULTS
Forty-five patients had postoperatively done well without any complications. There were 3 cases of hemodynamic instability and one case of cardiac ischemia which resolved in one to two days. One patient developed mild hoarseness. One complicated with bacteremia due to deep vein catheter insertion. Two patients experienced brain hemorrhage. None of this series occurred perioperative brain ischemia.


CONCLUSIONS
Tight carotid stenosis indicates a need for expeditious carotid endarterectomy with very low rates of brain ischemia. Intraoperative shunting is seldom necessary. Postoperative hyperperfusion syndrome and brain hemorrhage should be worried. Micro-endarterectomy can effectively prevent from restenosis.
Department of Neurosurgery, General Hospital of People's Liberation Army, Beijing 100853, China. shjwkk@sina.com
Ding-biao
DB
Zhou
Bai-nan
BN
Xu
Xin-guang
XG
Yu
Bo
B
Bu
Yan
Y
Jiang
Xiao-dong
XD
Ma
Ru-yuan
RY
Zhu
Li-feng
LF
Chen
Ping
P
Zhu
D000328:Adult; D000368:Aged; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents