ABSTRACT
OBJECTIVE: The aim of our study was to identify risk factors for early restenosis after carotid endarterectomy (CEA). METHODS: Prospective follow-up of 497 primary CEAs was performed at 3, 6, 12 and 24 months by clinical assessment and duplex ultrasound to identify > or = 50% restenosis. RESULTS: Early restenosis occurred in 71 (14.3%) patients. By univariate analysis high carotid clamping time (CCT) (p = 0.002) and absence of shunt use (p = 0.03) were related to early restenosis. High CCT was the only independent predictor of early restenosis in a forward stepwise logistic regression model (OR = 2.25; CI 1.2-4.1; p = 0.008). CONCLUSIONS: Carotid clamping time may be a novel risk factor for early restenosis.
Subject(s)
Carotid Stenosis/etiology , Carotid Stenosis/surgery , Endarterectomy, Carotid/adverse effects , Adult , Aged , Aged, 80 and over , Carotid Stenosis/diagnosis , Constriction , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Risk Factors , Time Factors , Vascular PatencyABSTRACT
The aim of this study was to present early and late results of carotid endarterectomy (CEA). We evaluated prospectively 270 CEA performed from 1990 to 1996. More of our patients were men (62%), their age ranged from 28 to 82 years (mean 62.4). Preoperative high grade stenosis (> 70%) of internal carotid artery stenosis was recognized in over 91% of patients according to duplex examination. All operations were performed by the same surgical team with the use of standard CEA without patching. General anaesthesia was used to the middle of 1993. Then all the patients were operated on under regional anaesthesia. Our follow-up consisted of clinical and duplex-scan examination performed regularly from 3 to 72 months after CEA. In the immediate postoperative period (30 days) four patients died (mortality rate 1.5%), mostly due to MI. The long term (72 months) follow-up revealed 12 deaths mostly due to heart attacks or cancer. We observed 11 high grade (> 70%) late recurrent stenoses. There were no deaths due to stroke from the operated artery. Duplex-scan of carotid arteries is a very effective and safe method of preoperative and postoperative evaluation. Regional anaesthesia allows direct estimation of neurological statement during operation. CEA is the only one method of stroke prevention in patients with symptomatic high-grade stenoses.
