The Turkish Journal of Vascular Surgery
Yazarlar: -
Konular:-
Anahtar Kelimeler:Carotid endarterectomy,Contralateral total occlusion
Özet: Purpose: To asses the demographic properties, risk factors, early and later results in patients who have undergone endarterectomy due to occlusive disease of carotid artery and have complete occlusion of the contralateral carotid artery. Methods: In the last 7 years, 34 patients who have undergone carotid endarterectomy and have contralateral complete occlusion of the carotid artery, were re-evaluated with hospital records, prospective carotis endarterectomy work sheets, outpatient records and telephone interview. Demographic data, risk factors, surgical techniques, early and late results are compared with the rest of our carotid endarterectomy patients and literature series. Results: Mean age of the patients in this pre-described group was 61.3+ 10.6 years and 4 of them (11.4%) were females. Presence of diabetes mellitus (29.4%), hypertension (73.5%), hypercholesterolemia (61.7%), smoking history (82.3%) and presence of atherosclerotic coronary artery disease (73.5%) were met frequently. Combined one-stage coronary-carotid artery surgery was performed in 8 of the patients in this presented series. Carotid artery disease symptoms were much more frequents in this group of patients when compared with patients who have patent contralteral carotid arteries (p<0.001). Utilization of intraluminal shunt during the endarterectomy procedure was significantly higher in contralateral total occlusion group (p<0.0001). Early mortality rate was 2.9% (n=1). Late follow up data were achieved in 29 patients with a mean 28±22 months (1-79 months). Mean acturial survival was 65±7 months (CI 95%: 51-78 months). Conclusion: Early and late term survival rates in patients who have undergone carotid endarterectomy with contralateral occlusion are not different from the patients with patent contralateral carotid artery. The management and control of the risk factors in this subgroup of patients are effective on the early and late term survival. Standards of surgical technique is effective on the success of the surgery. (Turkish J Vasc Surg 2003; 12(1): 5-10)