[How does carotid artery stenosis increase?]. / Jak powieksza sie zwezenie tetnicy szyjnej?

In 25 patients with carotid artery stenosis equal or higher than 40% colour doppler examinations were performed 105 times. The aim of this study was estimate the dynamics of progress of carotid artery stenosis. The mean time of observation was 22.5 months. In 11 (44%) patients there was no progress of stenosis, in 6 (24%) a leap progress over 30% of arterial lumen, and in 8 (32%) patients the progress of carotid artery stenosis were gradual and slow. The leap progress of carotid artery stenosis was usually caused by eruption or dissection of atherosclerotic plaque located in carotid bifurcation and this situation poses especially high risk of stroke.

[Time and conditions of cerebral ischemic symptoms appearing during carotid endarterectomy under local anesthesia]. / Czas i okolicznosci wystapienia objawów niedokrwienia mózgu podczas operacji tetnic szyjnych w znieczuleniu miejscowym.

In the 1994-1997 238 carotid endarterectomies (CEA) were performed under regional anaesthesia (cervical block) for carotid artery stenosis. In 30 CEA indwelling shunt was necessary. Among 30 patients with shunt 19 (63%) had a stroke before surgery, then 9 (30%) had contralateral internal carotid artery occlusion. Among entire group of 238 patients with CEA 56 (23.5%) had a stroke before surgery and 27 (11.4%) contralateral internal carotid artery occlusion. In our opinion the strongest factor influencing neurological deficiency after clamping trial, is a history of stroke before surgery and in a less degree contralateral internal carotid artery occlusion. The mean time of the neurological deficit during clamping trial was 27 seconds and varied from 5 to 100 sec. and never appeared after 2 minutes of mentioned trial. For that reason we consider 2 minutes clamping trial as sufficient for detection of neurological deficit during CEA under local anaesthesia.