Open AccessInfluence of contralateral stenosis on long‐term mortality rate following carotid surgery
Author(s) -
Black D.,
Renwick P.,
Naidu S.,
McCollum P.
Publication year - 1999
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1046/j.1365-2168.1999.0699c.x
Subject(s) - medicine , perioperative , stenosis , carotid endarterectomy , stroke (engine) , surgery , life expectancy , adverse effect , mortality rate , survival rate , population , cardiology , mechanical engineering , environmental health , engineering
Background: Recent evidence suggests that high‐grade contralateral stenosis has an adverse effect on perioperative morbidity in carotid endarterectomy (CEA). The relationship between contralateral high‐grade stenosis and long‐term survival after CEA was examined. Methods: Three hundred and twenty‐seven patients undergoing 333 CEA operations were entered prospectively into a database and long‐term follow‐up was instituted. Cardiac and stroke risk factors were identified before operation and correlated with long‐term survival and cause of death. Results: Mean age at operation was 68 (range 42–86) years. Median follow‐up was 2 (range 1–8) years. There were 45 deaths (seven perioperative), 17 myocardial, 16 from stroke (four perioperative), five from neoplasia, three respiratory and four others. The cumulative 5‐year survival rate was 75 per cent. Patients with high‐grade contralateral stenosis (greater than 80 per cent) had a significantly reduced life expectancy after CEA ( P < 0·05). Conclusion: Severe contralateral carotid disease is not only an adverse perioperative risk factor but also has negative implications for survival of the patient in the longer term. Following CEA, patients in general have a lower life expectancy than a normal age‐matched population. © 1999 British Journal of Surgery Society Ltd