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Updated: Oct 24, 2026
Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
Does severe contralateral carotid artery stenosis affect the outcomes of carotid endarterectomy?
Serkan Burç Deser1, Mustafa Kemal Demirağ1, Fersat Kolbakır1
1Department of Cardiovascular Surgery, Medicine Faculty of Ondokuz Mayıs University, Samsun, Turkey.
Insights
Severe contralateral internal carotid artery stenosis does not increase stroke or mortality risk after carotid endarterectomy. Patients can undergo the procedure safely with careful monitoring, as complication rates remain acceptable.
Area of Science:
- Vascular Surgery
- Cerebrovascular Disease
- Neurosurgery
Background:
- Carotid artery endarterectomy (CEA) is a common procedure to prevent stroke.
- The impact of contralateral internal carotid artery stenosis on CEA outcomes is debated.
- Understanding these risks is crucial for patient selection and surgical planning.
Purpose of the Study:
- To evaluate the effect of contralateral internal carotid artery stenosis on postoperative stroke and mortality.
- To assess blood pressure alterations following CEA in patients with varying degrees of contralateral stenosis.
- To determine if severe contralateral stenosis impacts CEA safety and outcomes.
Main Methods:
- Retrospective analysis of 152 CEAs in 141 patients (2009-2017).
- Patients divided into groups based on contralateral internal carotid artery stenosis severity (<70% vs. ≥70%).
- Comparison of postoperative stroke, mortality, blood pressure, and non-neurological complications between groups.
Main Results:
- No significant difference in postoperative stroke (7.6% vs. 3.1%) or mortality (3.8% vs. 2.1%) rates.
- Postoperative blood pressure alterations and non-neurological complications were similar between groups.
- Patients with severe contralateral stenosis were younger (p=0.005).
Conclusions:
- Contralateral severe internal carotid artery stenosis does not elevate the risk of postoperative stroke or mortality after CEA.
- CEA can be safely performed in patients with contralateral severe stenosis.
- Strict perioperative hemodynamic monitoring is recommended for optimal outcomes.
Background:
This study aims to evaluate the effect of contralateral internal carotid artery stenosis on postoperative stroke and mortality rate and blood pressure alterations following carotid artery endarterectomy.
Methods:
Between January 2009 and April 2017, a total of 152 carotid artery endarterectomy operations in 141 consecutive patients (30 females, 111 males; mean age 70.0±10.2 years; range, 48 to 92 years) with internal carotid artery stenosis were retrospectively analyzed. The patients were divided into two groups as those with contralateral internal carotid artery stenosis <70% (n=95) and contralateral internal carotid artery stenosis ?70% (n=26). Stroke and mortality rates in the early postoperative period (within the first 30 days), postoperative blood pressure alterations at six and 24 hours, non-neurological outcomes, and baseline demographic characteristics were analyzed and compared between the groups.
Results:
Both groups showed similar results in terms of the demographic characteristics. There was no statistically significant difference in the postoperative blood pressure alterations at six (p=0.917) and 24 hours (p=0.6), stroke rate (7.6% vs. 3.1%, p=0.282), mortality rate (3.8% vs. 2.1%, p=0.519), non-neurological complications (15.3% vs. 11.4%, p=0.736), and length of hospital stay (p>0.05) between the groups. The patients with contralateral severe internal carotid artery stenosis were younger (p=0.005).
Conclusion:
The present study shows that the presence of a contralateral severe internal carotid artery stenosis does not increase the risk of postoperative stroke and mortality rates and blood pressure alterations. Therefore, carotid artery endarterectomy can be performed with acceptable complication rates in patients with contralateral severe internal carotid artery stenosis with strict perioperative hemodynamic monitoring.
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