Open AccessCorrelation of Postoperative and Two-year Followup Angiography with Neurological Function in 99 Carotid Endarterectomies in 86 Consecutive Patients
Author(s) -
Thoralf M. Sundt,
O. Wayne Houser,
Nicolee C. Fode,
Jack P. Whisnant
Publication year - 1986
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198601000-00015
Subject(s) - medicine , stenosis , internal carotid artery , digital subtraction angiography , asymptomatic , occlusion , surgery , angiography , stroke (engine) , common carotid artery , radiology , carotid arteries , mechanical engineering , engineering
Eighty-six consecutive patients in 1982 underwent 99 endarterectomies and routine postoperative digital subtraction angiography. Ten vessels were closed primarily and 89 with a patch graft. Minor morbidity was 2%, major morbidity 0%, and mortality 1%, but these varied according to the patient's preoperative medical and neurological function and angiographic findings. Postoperative patency for the common carotid artery (CCA) and internal carotid artery (ICA) was 100% and for the external carotid artery (ECA) 97%. Seventy-nine vessels were evaluated by a DSA 2 years after surgery. There was one asymptomatic occlusion in follow-up and one symptomatic re-stenosis in a patient with a proven heparin induced hypercoagulability state. The three postoperative ECA occlusions were associated with a lethal postoperative stroke, the only ICA occlusion in follow-up, and a 50% stenosis of the CCA in follow-up at the site of ECA occlusion. Vein patch grafting protected the ICA but not the CCA from recurrent stenosis. The carotid slim sign on preoperative angiograms is judged to indicate a patient at high risk of stroke morbidity.