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Progression of carotid disease after endarterectomy: A Doppler ultrasound study
Author(s) -
Norrving Bo,
Nilsson Bengt,
Olsson JanEdvin
Publication year - 1982
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410120608
Subject(s) - carotid endarterectomy , medicine , doppler ultrasound , radiology , disease , endarterectomy , ultrasound , doppler effect , vascular disease , cardiology , stenosis , physics , astronomy
The clinical prognosis and evolution of carotid lesions after unilateral endarterectomy were determined in 64 patients examined 1 to 13 years after surgery (mean observation period, 6 years). Surgery mainly was confined to symptomatic patients with a stenosis only on the appropriate side. Average annual stroke rate was 1.6% on the operated and 0.8% on the nonoperated side. Direct Doppler examination at follow‐up revealed a recurrent stenosis (≥50%) or occlusion in 36% of the operated carotid arteries, not significantly different from the proportion of progressive carotid lesions on the nonoperated side (27%). In total, 43.8% of the patients had developed new lesions in one or both carotid arteries, as compared to previous angiographic findings. About 30% of the progressive lesions were associated with symptoms of transient ischemic attacks or stroke, as opposed to 5.5% of vessels without progression of lesions ( p < 0.001). The incidence of recurrent stenosis on the operated side is considerably higher than that previously reported for symptomatic recurrent stenosis, but may represent the natural course of carotid disease in this population, in which carotid surgery thus should not be regarded as definitive treatment.