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Simultaneous bilateral carotid endarterectomy: our first experience.
1Department of Thoracic and Cardiovascular Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Summary
Simultaneous bilateral carotid endarterectomies (SBCE) show promising results, with comparable outcomes to staged procedures. Careful patient selection and surgical technique are key for safe SBCE.
Area of Science:
- Vascular Surgery
- Cerebrovascular Surgery
Background:
- Bilateral carotid artery stenosis requires surgical consideration.
- Simultaneous bilateral carotid endarterectomy (SBCE) is an alternative to staged procedures.
Purpose of the Study:
- To compare outcomes of simultaneous bilateral carotid endarterectomies (SBCE) with staged bilateral endarterectomies.
- To discuss patient selection criteria for SBCE.
Main Methods:
- Compared 6 patients undergoing 12 SBCE (Group A) with 20 patients undergoing 40 staged bilateral endarterectomies (Group B).
- Indications, surgical management, and risk factors were similar between groups.
- No shunts or patches were used; occlusion times were recorded.
Main Results:
- Outcomes were comparable between SBCE and staged procedures.
- SBCE group had no major neurological complications, only transient hypoglossal paresis.
- Staged group had one transient ischemic attack (TIA); no mortality or permanent neurological damage in either group.
Conclusions:
- SBCE appears safe and effective in experienced hands.
- Improved preoperative assessment of the circle of Willis and meticulous technique enhance SBCE safety.
- Further studies with larger patient numbers are needed to confirm findings.