Resultats immediats et a long terme de l'endarterectomie carotidienne: l'experience Zurichoise. [Immediate and long-term results of carotid endarterectomy: the Zurich experience]

Détails

ID Serval
serval:BIB_C96741A8F5D4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Resultats immediats et a long terme de l'endarterectomie carotidienne: l'experience Zurichoise. [Immediate and long-term results of carotid endarterectomy: the Zurich experience]
Périodique
Schweizerische Medizinische Wochenschrift
Auteur(s)
Carrel  T., Pasic  M., Niederhauser  U., Laske  A., Stingl  B., Stillhard  G., von Segesser  L., Turina  M.
ISSN
0036-7672
Statut éditorial
Publié
Date de publication
11/1992
Peer-reviewed
Oui
Volume
122
Numéro
45
Pages
1708-15
Notes
English Abstract
Journal Article --- Old month value: Nov 7
Résumé
Extracardial carotid artery disease is a frequent cause of transient ischemic attack and of cerebral infarction. The records of 485 patients who underwent carotid endarterectomy between 1978 and 1991 were reviewed, with special attention to both cardiac and neurological complications. 432 patients had symptomatic carotid disease whereas 53 were asymptomatic but presented with significant carotid stenosis or a large ulceration at doppler-duplex examination and/or angiography. These examinations showed the following lesions in symptomatic patients: unilateral stenosis > 75% (331; 68.5%), ulceration (41; 8.5%), bilateral stenosis (61; 12.5%) and unilateral stenosis with contralateral occlusion (51; 10.5%). Intraluminal shunt was used in nearly all patients whereas special management of cerebral metabolism (intraoperative electroencephalogram, somatosensory evoked potentials) were used in high-risk patients only. Overall early mortality was 1.8%. Three patients died from the sequelae of a neurologic injury, whereas six patients died from myocardial infarction or intractable arrhythmia. Mortality decreased from 2.4% between 1978 and 1984 to 0.8% between 1985 and 1991. At 6 and 8 years, actuarial survival rates of 88.1% and 76.1% and stroke-free survival rates of 86% and 81.5% were observed. Late mortality was essentially due to ischemic cardiac complications (38.5% of the actuarial late mortality at 8 years). Review of the literature shows that carotid endarterectomy is the treatment of choice for symptomatic high-grade extracranial carotid stenosis in patients who are not high-risk candidates.(ABSTRACT TRUNCATED AT 250 WORDS)
Mots-clé
Aged Aged, 80 and over Carotid Artery Thrombosis/complications/*surgery *Endarterectomy, Carotid/mortality Female Humans Ischemic Attack, Transient/etiology Male Middle Aged Retinal Artery Occlusion/etiology Retrospective Studies
Pubmed
Web of science
Création de la notice
14/02/2008 14:17
Dernière modification de la notice
20/08/2019 15:44
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