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One year of prospective follow‐up after carotid thrombendarterectomy – A clinical and duplex study
Author(s) -
Zbornikova V.,
Lassvik C.,
Alm A.
Publication year - 1998
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1998.tb07304.x
Subject(s) - medicine , occlusion , stenosis , duplex scanning , surgery , prospective cohort study , stroke (engine) , restenosis , angiography , radiology , stent , mechanical engineering , engineering
Objectives – The aim of this study was to make a prospective evaluation of the carotid arteries after thrombendarterectomy by combined clinical and duplex examination, to define an exact time of development of postoperative restenosis/occlusion and to relate early morphological changes to occurrences of new neurological events. Material and methods – Sixty‐four patients (66 operations), 48 men and 16 women, mean age of 63±8 (SD) years, with transient ischaemic attacks or minor stroke were examined clinically 1 day before and after the carotid surgery. All except 3 patients had stenosis ±50%. Duplex scanning and periorbital Doppler were performed before aortic arch angiography, within 2 weeks after operation and thereafter at 3, 6 and 12 months. Results – 10 patients experienced minor stroke and one major stroke after operation, in 5 patients connected with occlusion on the operated side, which differed ( P <0.01) from 56 patients with open vessels in whom 6 ipsilateral minor strokes occurred. Four of 6 patients with minor stroke, in whom the operated vessels were open, recovered, whereas the neurological deficits were permanent in all 5 patients with occlusion ( P <0.05). Duplex scanning confirmed 10 new occlusions and 2 high grade stenoses>75% postoperatively. Persisting morbidity was 11% and no mortality at 3 months' control. At 12 months' control, 1 patient had stroke related to preoperatively diagnosed occlusion on the non‐operated side and 14 flow reducing lesions>75% (11 occlusions and 3 stenoses >75%) were found in 57 (24.6%) of examined vessels. Conclusion – occlusion occurs in immediate postoperative period and seems to be a serious complication connected with significantly higher number of persistent neurological events than open vessels.