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Annals of Surgery logoLink to Annals of Surgery
. 1986 Jan;203(1):90–100. doi: 10.1097/00000658-198601000-00015

Correlation of postoperative and two-year follow-up angiography with neurological function in 99 carotid endarterectomies in 86 consecutive patients.

T M Sundt Jr, O W Houser, N C Fode, J P Whisnant
PMCID: PMC1251044  PMID: 3942425

Abstract

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.

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Selected References

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