Carotid endarterectomy outcome is not affected in patients with a contralateral carotid artery occlusion

• Published in: The American journal of surgery 1998-07, Vol.176 (1), p.30-33
• Main Authors: Aungst, Matthew, Gahtan, Vivian, Berkowitz, Henry, Roberts, Andrew B., Kerstein, Morris D.
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty; Anticoagulants; Asymptomatic; Atherosclerosis; Biological and medical sciences; Blood vessels; Cardiac arrhythmia; Carotid arteries; Carotid artery; Carotid Artery, Internal; Carotid Stenosis - complications; Carotid Stenosis - mortality; Carotid Stenosis - surgery; Cerebral blood flow; Cerebrovascular Disorders - etiology; Cerebrovascular Disorders - mortality; Death; EEG; Electroencephalography; Endarterectomy, Carotid; Female; Follow-Up Studies; Heart attacks; Heart failure; Hemorrhage; Humans; Hypertension; Ischemia; Life Tables; Male; Medical sciences; Monitoring, Intraoperative; Mortality; Occlusion; Patients; Retrospective Studies; Risk factors; Stroke; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival; Survival Rate; Tables (data); Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Veins & arteries
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(98)00098-1

Background: The purpose of this retrospective patient/control patient study was to determine perioperative risk and long-term benefits of carotid endarterectomy contralateral to an occluded internal carotid artery. Methods: Thirty-seven patients undergoing carotid endarterectomy contralateral to an occluded internal carotid artery were each paired with two control group patients (n = 74) undergoing carotid endarterectomy contralateral to a patent internal carotid artery. Patients preferentially underwent electroencephalographic monitoring, selective shunting, and patch angioplasty for vessel closure. Results: The perioperative rate of stroke or death was 5% (n = 2) in the occluded group and 3% (n = 2) in the control group. Ninety-two percent of the occluded group and 96% of the control patients were stroke-free over a mean follow-up of 23.8 and 27.2 months, respectively. No statistical difference was noted between groups for perioperative rate of stroke or death ( P = 0.60), mean stroke-free rates ( P = 0.37), stroke rate by life-table analysis ( P = 0.33), or survival by life-table analysis ( P = 0.43). Conclusions: Patients who have carotid endarterectomy performed contralateral to an occluded internal carotid artery showed no difference for perioperative stroke or death, late stroke, or survival.