Clinical outcomes of carotid endarterectomy in patients with carotid artery tandem lesions.

Abstract:

BACKGROUND AND PURPOSE:When carotid artery tandem lesions are present, the benefits of carotid endarterectomy (CEA) to reduce recurrent stroke remain uncertain. The present retrospective cohort study aimed to determine the clinical outcomes of CEA for carotid artery tandem stenosis that was diagnosed by contrast-enhanced magnetic resonance angiography. METHODS:Six hundred forty-seven consecutive patients underwent CEA between January 2001 and December 2010. Tandem stenosis, defined as a significant carotid bifurcation stenosis and identifiable stenosis of ≥50% of any downstream distal cerebral artery, was identified in 92 patients (14.2%) by contrast-enhanced magnetic resonance angiography. Patients with and without tandem stenosis were compared in terms of CEA outcomes. The primary end point was the composite of any stroke, myocardial infarction, or death during the periprocedural period or ipsilateral stroke within 4 years after CEA. RESULTS:Tandem stenosis did not associate with ipsilateral stroke during postoperative follow-up. The 2 groups did not differ in terms of estimated 4-year primary end point rates (8.7% versus 3.8%; P=0.07) or ipsilateral stroke-free (P=0.56), any stroke-free (P=0.89), or overall survival (P=0.41) rates. CONCLUSIONS:After diagnosis by contrast-enhanced magnetic resonance angiography, patients with and without tandem stenosis had similar rates of stroke and death.

journal_name

Stroke

journal_title

Stroke

authors

Han Y,Park H,Kwon SU,Kang DW,Lee DH,Kwon H,Kwon TW,Cho YP,Kim GE

doi

10.1161/STROKEAHA.114.007181

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

3443-6

issue

11

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.114.007181

journal_volume

45

pub_type

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