Abstract
This paper offers a computer-assisted analysis of the author's experience with 234 carotid endarterectomy procedures in 188 patients. The patients' ages, sex, smoking habits, symptoms, carotid bruits, arteriographic findings and associated diseases are summarized. There were 28 operations in asymptomatic patients, 170 operations in patients with transient ischemic attacks (TIA), 35-operations in patients with a completed stroke and one operation in a patient with a stroke in evolution. After surgery, transient neurologic deficits were noted in both the asymptomatic group (two instances) and the group with TIA (5 instances); permanent neurologic deficits followed 4 operations in the TIA group (2.4% incidence). Two operative deaths occurred in the TIA group (1.2% mortality), and 10 deaths occured after operation for a completed stroke (28.6% mortality). Nine of the deaths in the completed stroke group followed operations performed less than 2 weeks after a stroke. A 100% followup was obtained, and the average period of followup was 48 months. Of the patients surviving operation, all in the asymptomatic group were judged functionally normal, 94% of the TIA group were either functionally normal or improved, 76% with a completed stroke were improved, and the patient with a stroke in evolution was unchanged. There were 69 late deaths with heart disease accounting for 58% of the deaths and stroke another 17%.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blaisdell W. F., Clauss R. H., Galbraith J. G., Imparato A. M., Wylie E. J. Joint study of extracranial arterial occlusion. IV. A review of surgical considerations. JAMA. 1969 Sep 22;209(12):1889–1895. [PubMed] [Google Scholar]
- DEBAKEY M. E., CRAWFORD E. S., COOLEY D. A., MORRIS G. C., Jr, GARRET H. E., FIELDS W. S. CEREBRAL ARTERIAL INSUFFICIENCY: ONE TO 11-YEAR RESULTS FOLLOWING ARTERIAL RECONSTRUCTIVE OPERATION. Ann Surg. 1965 Jun;161:921–945. doi: 10.1097/00000658-196506000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DeWeese J. A., Rob C. G., Satran R., Marsh D. O., Joynt R. J., Lipchik E. O., Zehl D. N. Endarterectomy for atherosclerotic lesions of the carotid artery. J Cardiovasc Surg (Torino) 1971 Jul-Aug;12(4):299–308. [PubMed] [Google Scholar]
- DeWeese J. A., Rob C. G., Satran R., Marsh D. O., Joynt R. J., Summers D., Nichols C. Results of carotid endarterectomies for transient ischemic attacks-five years later. Ann Surg. 1973 Sep;178(3):258–264. doi: 10.1097/00000658-197309000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- EASTCOTT H. H., PICKERING G. W., ROB C. G. Reconstruction of internal carotid artery in a patient with intermittent attacks of hemiplegia. Lancet. 1954 Nov 13;267(6846):994–996. doi: 10.1016/s0140-6736(54)90544-9. [DOI] [PubMed] [Google Scholar]
- Edwards W. S., Wilson T. A., Bennett A. The long-term effectiveness of carotid endarterectomy in prevention of strokes. Ann Surg. 1968 Oct;168(4):765–770. doi: 10.1097/00000658-196810000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fields W. S., Maslenikov V., Meyer J. S., Hass W. K., Remington R. D., Macdonald M. Joint study of extracranial arterial occlusion. V. Progress report of prognosis following surgery or nonsurgical treatment for transient cerebral ischemic attacks and cervical carotid artery lesions. JAMA. 1970 Mar 23;211(12):1993–2003. doi: 10.1001/jama.211.12.1993. [DOI] [PubMed] [Google Scholar]
- Javid H., Ostermiller W. E., Jr, Hengesh J. W., Dye W. S., Najafi H., Julian O. C. Natural history of carotid bifurcation atheroma. Surgery. 1970 Jan;67(1):80–86. [PubMed] [Google Scholar]
- Lefrak E. A., Guinn G. A. Prophylactic carotid artery surgery in patients requiring a second operation. South Med J. 1974 Feb;67(2):185–189. doi: 10.1097/00007611-197402000-00014. [DOI] [PubMed] [Google Scholar]
- Levin S. M., Sondheimer F. K. Stenosis of the contralateral asymptomatic carotid artery--to operate or not? Vasc Surg. 1973 Jan-Feb;7(1):3–13. doi: 10.1177/153857447300700102. [DOI] [PubMed] [Google Scholar]
- Thompson J. E., Austin D. J., Patman R. D. Carotid endarterectomy for cerebrovascular insufficiency: long-term results in 592 patients followed up to thirteen years. Ann Surg. 1970 Oct;172(4):663–679. doi: 10.1097/00000658-197010000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thompson J. E. The development of carotid artery surgery. Arch Surg. 1973 Nov;107(5):643–648. doi: 10.1001/archsurg.1973.01350230003002. [DOI] [PubMed] [Google Scholar]
- Treiman R. L., Foran R. F., Shore E. H., Levin P. M. Carotid bruit. Significance in patients undergoing an abdominal aortic operation. Arch Surg. 1973 Jun;106(6):803–805. doi: 10.1001/archsurg.1973.01350180041013. [DOI] [PubMed] [Google Scholar]