Carotid endarterectomy in high risk patients.

Abstract:

:We elected to compare the clinical outcomes of carotid endarterectomy (CEA) patients who were thought to be at increased risk for peri-operative complications because of advanced age (> 79 years), medical comorbidities and contralateral internal carotid artery occlusion to patients without these risk factors. A prospective series of 875 CEAs done using regional anesthesia were analyzed. All patients were operated upon under the direction of one neurosurgeon (REH). Clinical outcomes measures evaluated were any stroke, death or myocardial infarction within 30 days of operation. All patients were followed to a clinical endpoint and/or six weeks post-operatively. The incidence of adverse clinical outcomes in the suspected high risk patients was compared to the incidence in the entire series using contingency table analysis (Chi-square and Fisher's exact test). Twenty strokes (2.3%), four myocardial infarctions (0.5%) and three deaths (0.3%) occurred within 30 days of CEA. None of the suspected risk factors was associated with a significantly (p < 0.05) increased risk of peri-operative morbidity or mortality. CEA using regional anesthesia can be performed in patients with advanced age, diabetes mellitus, atherosclerotic coronary vascular disease and contralateral ICA occlusion with acceptably low peri-operative morbidity.

journal_name

Neurol Res

journal_title

Neurological research

authors

Harbaugh RE,Magnadottir HB

doi

10.1179/016164102101199936

subject

Has Abstract

pub_date

2002-01-01 00:00:00

pages

S66-70

eissn

0161-6412

issn

1743-1328

journal_volume

24 Suppl 1

pub_type

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