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The asymptomatic bruit
Insights
Prophylactic carotid endarterectomy for asymptomatic carotid bruit is safe and effective. This procedure in carefully selected patients prevents future neurologic complications, with 100% of survivors remaining symptom-free long-term.
Area of Science:
- Vascular Surgery
- Neurology
- Preventive Medicine
Background:
- Asymptomatic midcervical bruit can indicate carotid artery disease.
- The risk of neurologic events in these patients is a concern, especially before elective surgery.
Purpose of the Study:
- To evaluate the safety and long-term efficacy of prophylactic carotid endarterectomy in patients with asymptomatic carotid bruit.
- To determine if this intervention prevents future neurologic complications.
Main Methods:
- A retrospective review of 144 carotid endarterectomies in 108 patients.
- Procedures were performed prior to anticipated elective surgery.
- Long-term follow-up was conducted on survivors.
Main Results:
- Carotid endarterectomy demonstrated acceptable operative morbidity and mortality.
- 100% of long-term survivors remained free of neurologic symptoms or fatalities.
- No future neurologic complications were observed in the follow-up period.
Conclusions:
- Prophylactic carotid endarterectomy is a viable option for carefully selected patients with asymptomatic carotid bruit.
- The procedure effectively prevents future neurologic complications.
- This intervention improves long-term outcomes for patients undergoing elective surgery.
Abstract:
A review of 144 carotid endarterectomies performed in 108 patients at the Oklahoma Health Science Center over the past six years showed an acceptable operative morbidity and mortality in group of patients with an asymptomatic midcervical bruit who underwent prophylactic carotid endarterectomy prior to anticipated elective surgery. Long-term follow-up showed these patients to be free of neurologic symptoms of fatalities in 100 per cent of long-term survivors and suggests that carefully selected patients with an asymptomatic bruit may undergo carotid endarterectomy to prevent future neurologic complication.