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Long-term results after carotid endarterectomy for carotid artery stenosis with contralateral occlusion
F Vermassen1, A Flamme, J De Roose
1Department of Vascular Surgery, University Hospital, Ghent, Belgium.
Insights
Carotid endarterectomy is a safe and effective treatment for patients with one blocked carotid artery and a narrowed artery on the other side. This procedure significantly reduces stroke risk and improves long-term survival rates.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiovascular Medicine
Background:
- Patients with unilateral internal carotid artery occlusion and contralateral stenosis face a heightened stroke risk.
- Cerebrovascular disease management requires careful consideration of surgical interventions.
Purpose of the Study:
- To evaluate the safety and long-term efficacy of carotid endarterectomy in patients with unilateral internal carotid artery occlusion and contralateral stenosis.
- To assess the impact of this surgical intervention on stroke incidence and patient survival.
Main Methods:
- A cohort of 44 patients with the specified condition underwent carotid endarterectomy.
- Patients were followed for a mean of 54 months (range 1-172 months) post-procedure.
- Life-table analysis was employed to determine stroke incidence and survival rates.
Main Results:
- Early mortality following endarterectomy was 2%.
- The annual incidence of new strokes was 0.6% per year.
- Survival rates were 78% at three years and 70% at five years.
Conclusions:
- Carotid endarterectomy is a safe procedure for patients with contralateral internal carotid artery occlusion.
- The intervention significantly improves the long-term prognosis for this high-risk patient group.
- Surgical revascularization should be considered for selected patients with complex carotid artery disease.
Abstract:
Patients with one internal carotid artery occlusion and a contralateral stenosis run a significantly higher risk of stroke. We performed endarterectomy of the stenotic carotid in 44 such patients and followed them for mean 54 months (range 1-172 months). Early mortality was 2%. Life-table analysis shows that the incidence of a new stroke was 0.6% per year, the survival rate was 78% after three years, and 70% after five years. We conclude that carotid endarterectomy can be safely performed in patients with contralateral internal carotid artery occlusion and can significantly improve the long-term prognosis of these patients.