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[Supra-aortic extracranial revascularization in cerebrovascular disorders with special reference to stage
G Herbon1, J Pfannschmidt, H Korb
1Klinik und Poliklinik für Herzchirurgie, Universität zu Köln.
Insights
Carotid endarterectomy is a surgical option for cerebrovascular insufficiency caused by extracranial arterial disease. This study evaluated 216 patients, finding a 5.1% mortality rate and mixed neurological outcomes post-surgery.
Area of Science:
- Neurology
- Vascular Surgery
Context:
- Cerebrovascular insufficiency due to extracranial occlusive arterial disease remains a debated surgical indication.
- Carotid endarterectomy is a primary surgical intervention for this condition.
Purpose:
- To evaluate the efficacy and outcomes of carotid endarterectomy in patients with cerebrovascular insufficiency.
- To assess the hospital mortality rate and long-term neurological status after the procedure.
Summary:
- A series of 216 patients underwent carotid endarterectomy between 1980 and 1988.
- The hospital mortality rate was 5.1%.
- Follow-up assessments (mean 8.1 months) showed unchanged neurological status in 29% and progression in 5.7% of patients.
Impact:
- Provides data on the outcomes of carotid endarterectomy, contributing to the ongoing discussion on its surgical value.
- Highlights the importance of clinical and Doppler sonographic follow-up for assessing surgical results in cerebrovascular disease.
Abstract:
The opinions concerning the value of a surgical approach in cerebrovascular insufficiency due to extracranial occlusive arterial disease are still controverse. We analysed a consecutive series of 216 patients after carotid endarterectomy performed in the period of 1980 to 1988. The preoperative symptoms permitted a classification into the clinical groups I to IV according to Vollmar. All operations were done under standard conditions. An intraluminal shunt was used in 194 patients (90%). In 24 patients (11%) a bilateral carotid revascularisation was carried out. The hospital mortality rate in our groups of patients was 5.1%. In order to evaluate the results, Doppler sonographic and clinical examinations with a mean follow-up of 8.1 months (range: 3 to 60 months) were performed. The neurologic examination revealed an unchanged condition in 63 patients (29%). Twelve patients (5.7%) suffered from a progression of the neurologic disorders.