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Our first experience applying simultaneous bilateral carotid endarterectomy
P B Dimakakos1, B Arapoglou, M Papasava
1Vascular Unit, Medical School, University of Athens, Greece.
Summary
Simultaneous bilateral carotid endarterectomy (SBCE) is a rarely cited procedure. This study found SBCE results comparable to staged or unilateral procedures, suggesting it
Area of Science:
- Vascular Surgery
- Cerebrovascular Surgery
Background:
- Simultaneous bilateral carotid endarterectomy (SBCE) is infrequently documented in surgical literature.
- Limited data exists comparing SBCE to staged or unilateral carotid endarterectomy.
Purpose of the Study:
- To evaluate the safety and efficacy of simultaneous bilateral carotid endarterectomy (SBCE).
- To compare outcomes of SBCE with staged and unilateral carotid endarterectomies.
Main Methods:
- Retrospective comparison of 24 SBCEs (Group A) with 22 bilateral staged endarterectomies (Group B) and 155 unilateral endarterectomies (Group C).
- Surgical indications, management, and risk factors were analyzed across groups.
- Occlusion times and complication rates were assessed, with no shunt or patch used.
Main Results:
- Outcomes for SBCE were comparable to staged and unilateral procedures.
- The SBCE group experienced one transient ischemic attack (TIA) and one case of transient vocal cord paresis.
- No deaths, myocardial infarctions, respiratory issues, or permanent central nervous system damage were observed in the SBCE group.
Conclusions:
- Despite small patient numbers, SBCE appears to be a viable surgical option.
- Preoperative assessment of the circle of Willis, meticulous surgical technique, and careful patient selection are crucial for successful SBCE.
- SBCE may be encouraged as a surgical tactic under appropriate conditions.