Carotid redo surgery: both safe and durable.

Abstract:

AIM:To examine the outcomes and complications of surgery for recurrent carotid stenosis. METHODS:From 1974 to 2000, 1922 carotid endarterectomies were performed in our unit. A retrospective cohort analysis of these records identified 24 patients (1.2%) who underwent surgery for recurrent stenosis. RESULTS:There were 13 men and 11 women in the group. Median follow up was 7.2 years (interquartile range 4.4-12.4 years). The indication for redo surgery was either symptomatic severe (80-99%) or moderate (50-79%) restenosis, or severe asymptomatic (80-99%) restenosis. Repair was performed by patch angioplasty (88%), endarterectomy alone (8%) or interposition grafting (4%). Within the 30 day perioperative period there were no deaths, no strokes (major or minor), or significant cardiac morbidity. One patient (4%) developed a permanent spinal accessory nerve deficit. Another patient (4%) required further re-intervention for recurrent disease. CONCLUSIONS:Very low surgical morbidity and mortality was achieved in our unit by implementing a policy of selective re-intervention for carotid restenosis. Redo carotid endarterectomy can therefore be recommended as having no greater morbidity than primary carotid endarterectomy. Carotid angioplasty and stenting are not recommended as a routine alternative treatment.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Harris RA,Stow N,Fisher CM,Neale ML,Appleberg M

doi

10.1046/j.1445-2197.2003.t01-8-.x

keywords:

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

1000-3

issue

12

eissn

1445-1433

issn

1445-2197

journal_volume

73

pub_type

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