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[Predictors of long-term complications after carotid endarterectomy]

A N Kazantsev1, R S Tarasov1, N N Burkov1

  • 1Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.

Khirurgiia
|July 19, 2019
PubMed

Insights

Predictors of long-term complications after carotid endarterectomy (CEE) were identified. High SYNTAX score, unstable or occluded contralateral internal carotid artery (ICA), low ejection fraction, and prolonged cross-clamping are key risk factors.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Carotid endarterectomy (CEE) is a crucial procedure for managing occlusive-stenotic lesions of carotid arteries.
  • Understanding long-term complications post-CEE is vital for optimizing patient outcomes and treatment strategies.

Purpose of the Study:

  • To identify and analyze predictors of unfavorable cardiovascular events occurring within three years following carotid endarterectomy (CEE).
  • To establish a basis for developing prognostic models to guide treatment decisions in patients with supra-aortic vessel lesions.

Main Methods:

  • A cohort of 1035 patients undergoing CEE between 2011-2016 was analyzed.
  • Long-term follow-up averaged 42.4 months (approximately 3.5 years).
  • Stepwise logistic regression was employed to determine risk factors for adverse outcomes, including death, myocardial infarction, stroke/transient ischemic attack, and redo revascularization.

Main Results:

  • Several significant predictors of long-term complications were identified.
  • Key risk factors include a SYNTAX score of 33 or higher, unstable or occluded contralateral internal carotid artery (ICA), left ventricular ejection fraction (LVEF) below 39%, ICA cross-clamping exceeding 40 minutes, and prior coronary artery bypass grafting (CABG).

Conclusions:

  • The identified predictors are crucial for developing accurate prognostic models.
  • These models can significantly aid in determining the optimal treatment strategy for patients with occlusive-stenotic lesions of supra-aortic vessels.
Abstract

Keywords:
carotid endarterectomylong-term follow-upunfavorable prognostic factors

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