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[Endarterectomy of the internal carotid. Clinical experience]
1Istituto di I Patologia Chirurgica, Università di Cagliari.
Insights
This study evaluated 37 internal carotid endarterectomies in 33 patients, finding excellent long-term results in survivors despite significant operative morbidity and mortality. Prophylactic procedures showed good outcomes for preventing neurological deficits.
Area of Science:
- Vascular Surgery
- Cerebrovascular Disease Management
- Neurosurgery
Context:
- Internal carotid artery disease poses a significant risk for stroke.
- Surgical intervention, such as endarterectomy, is a key treatment modality.
- Patient outcomes depend on surgical technique and patient selection.
Purpose:
- To report the clinical experience and outcomes of internal carotid endarterectomies.
- To analyze results based on patient classification (asymptomatic, transient ischemic attack, stable neurological deficit, acute ischemia).
- To evaluate the effectiveness of thromboendarterectomy with and without patch angioplasty.
Summary:
- 37 internal carotid endarterectomies were performed on 33 patients across various neurological classifications.
- Operative mortality was 6% and morbidity was 22%.
- Late mortality was 19%, but survivors experienced excellent long-term results; 18% experienced postoperative stenosis, often without patch angioplasty.
Impact:
- This experience highlights the risks and benefits of carotid endarterectomy.
- Findings suggest that while the procedure carries risks, it can yield excellent long-term outcomes for survivors.
- The data on postoperative stenosis may inform future surgical technique optimization.
Abstract:
The authors report a clinical experience on 37 internal carotid endarterectomies of 33 patients classified as: group A (asymptomatic patients); 4 patients (13%), group B (RIA); 9 patients (27%), group C (stabilized neurological lesions); 19 patients (56%), group D (acute cerebral ischemia): 1 patient (3%). Sixteen thromboendarterectomies (43%) were carried on for the prophylaxis of neurological lesions, 20 (54%) to increase and balance the cerebral blood flow in patients with stable neurological lesions, 1 (3%) for acute cerebral ischemia. The overall operative mortality was 6%, the operative morbidity was 22%. The clinical follow-up concerned 26 patients: the overall mortality was 19%: in survivors the late results were excellent. The rate of postoperative stenosis was 18%: 80% of these arteries had been treated without a patch angioplasty.