2 research outputs found
Carotid endarterectomy: Results and long-term follow-up of a single institution
Objectives : To document our experiences, technical procedure and
outcomes of carotid endarterectomy (CEA) in patients with symptomatic
carotid stenosis. Material and Methods : A total of 49 consecutive
patients underwent 53 CEAs (three bilateral, one redo) for severe
carotid artery stenosis. There were 39 males and 10 females, with mean
age of 63 years. All patients underwent neck Doppler, computed
tomography/magnetic resonance angiography/digital substraction
angiography and a detailed cardiological evaluation. Antiplatelet drugs
were continued perioperatively. Surgery was performed under general
anesthesia with propofol cerebral protection, mild hypothermia and
continuous electroencephalogram monitoring. The procedure was done
under microscope and closure was done using 6-0 prolene. Clinical and
radiological follow-up was done. Results : Our mean follow-up was 4.69
years. All patients underwent primary suturing except one redo CEA done
with venous patch graft. Three patients required intraoperative
shunting. One patient died secondary to myocardial infarction
peroperatively prior to carotid manipulation. One patient had stroke
within 6 h, secondary to operative site intraluminal thrombus and was
re-explored. Two patients had transient postoperative hemiparesis and
aphasia while two patients had altered sensorium, all self-limiting,
with normal imaging. One patient developed temporary twelfth-nerve
paresis. One patient had persistent transient ischemic attack on the
follow-up. Thus, the perioperative mortality rate was 1.89% and stroke
rate was 1.89%. Conclusions : CEA for severe carotid stenosis is a safe
procedure with good protection from ischemic events. Detailed
preoperative cardiac evaluation and appropriate patient selection is
essential