Surgical experience with simultaneous bilateral carotid endarterectomies

Area of Science:

• Vascular Surgery
• Neurology
• Cardiology

Background:

• Bilateral carotid endarterectomy (BCE) is a surgical procedure to remove plaque from both carotid arteries.
• Stroke prevention is a critical concern for patients with significant carotid artery stenosis.

Purpose of the Study:

• To review the outcomes of eighty patients who underwent simultaneous bilateral carotid endarterectomy.
• To assess the hospital mortality, neurological deficits, and long-term functional status after BCE.

Main Methods:

• Retrospective review of eighty patients undergoing BCE under general anesthesia and heparinization.
• Use of an internal shunt in most cases (n=74).
• Assessment of hospital mortality, transient and permanent neurological deficits, and long-term follow-up (average 48 months).

Main Results:

• Hospital mortality was 3.8% (3 deaths).
• Transient neurological deficits occurred in 5% of patients (4/80).
• Permanent neurological deficits occurred in 5% of patients (4/80).
• At long-term follow-up, 85.7% of survivors were functionally normal or improved.
• Late deaths (10) were primarily due to heart disease (50%) and stroke (30%).

Conclusions:

• Simultaneous bilateral carotid endarterectomy is associated with acceptable hospital mortality and neurological complication rates.
• The procedure offers significant long-term functional benefits for stroke prevention.
• Long-term survival is influenced by cardiovascular and cerebrovascular events.