Evaluation of carotid endarterectomy in post cerebral stroke patients with significant carotid artery lesions

ABSTRACT

This study was carried out to evaluate the results of carotid endarterectomy after recovery from prior stroke due to a significant carotid artery lesion. Thirty-seven patients with prior for cerebral stroke were included [26 males 11 females, mean age = 64.5 years]. All patients had good functional recovery with minimal residual deficits. A corresponding significant carotid stenosis [> 70%] was present in 32 patients [86%] and an unstable ulcerated plaque in 5 patients [14%]. Carotid endarterectomy was done 30 days to 6 months post-stroke. Risk factors included smoking [73%], hypertension [68%], diabetes mellitus [57%], coronary artery disease [35%] and hyperlipidemia [41%]. Mean follow up was 18 months [range 6-37 months]. There was one postoperative death as a result of intraoperative stroke and another from myocardial infarction resulting in a combined perioperative stroke/mortality of 5.4%. No other neurological events were encountered during the rest of the follow up period. Complications related to the procedure included reactionary hemorrhage [2.7%], hoarseness of voice [5.4%], and transient ramus mandibularis palsy [2.7%]. This experience supports the benefit of carotid endarterectomy in post-stroke patients with significant carotid artery lesions. It is a safe and reliable procedure in preventing recurrent stroke in this group of patients