Resultats immediats et a long terme de l'endarterectomie carotidienne: l'experience Zurichoise. [Immediate and long-term results of carotid endarterectomy: the Zurich experience]
Details
Serval ID
serval:BIB_C96741A8F5D4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Resultats immediats et a long terme de l'endarterectomie carotidienne: l'experience Zurichoise. [Immediate and long-term results of carotid endarterectomy: the Zurich experience]
Journal
Schweizerische Medizinische Wochenschrift
ISSN
0036-7672
Publication state
Published
Issued date
11/1992
Peer-reviewed
Oui
Volume
122
Number
45
Pages
1708-15
Notes
English Abstract
Journal Article --- Old month value: Nov 7
Journal Article --- Old month value: Nov 7
Abstract
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)
Keywords
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
Create date
14/02/2008 15:17
Last modification date
20/08/2019 16:44