| Carotid endarterectomy in symptomatic elderly patients. | |
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MedLine Citation:
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PMID: 3374779 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fifty-three of 203 consecutive carotid endarterectomies (26%) performed on the Neurosurgical Service at the University of Iowa were in patients over 70 years of age (mean age, 73.4). This series included 38 men and 15 women. Thirty-three patients (62%) presented with transient ischemic attacks, and the remaining 38% were functional stroke patients. Medical risk factors in this group included hypertension in 70%, previous myocardial infarction in 26%, angina in 17%, peripheral vascular disease in 23%, and diabetes in 13%. Sixty-four per cent of the patients had been previously treated with antihypertensive drugs, 43% with antiplatelet agents, and 4% with anticoagulants. Noninvasive vascular evaluation was performed in 25 of 53 (47%) patients, and all underwent angiography before operation. There were no angiographic complications. All patients were operated on with full-channel electroencephalographic (EEG) monitoring. Indwelling shunts were required in 6 of 53 (11%) cases. Intraoperative heparin was given and not reversed; the mean dose was 5100 units. The mean clamp time was 48 minutes. Patch grafts, fashioned from common facial or saphenous veins, were used in 2 patients. Eight patients had contralateral carotid occlusions, but only 2 (25%) required indwelling shunt placement based on EEG criteria. There were no perioperative deaths in this series. One patient had a postoperative stroke, and 1 patient had a postoperative nonfatal myocardial infarction. Transient surgical complications included 3 wound hematomas, 1 wound abscess, and 2 self-limited cranial nerve palsies (13%).(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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C M Loftus; J Biller; J C Godersky; H P Adams; T Yamada; P S Edwards |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 22 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 1988 Apr |
Date Detail:
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Created Date: 1988-07-14 Completed Date: 1988-07-14 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 676-80 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Arterial Occlusive Diseases / complications, surgery* Carotid Artery Diseases / complications, surgery* Cerebrovascular Disorders / etiology, therapy Endarterectomy* Female Humans Ischemic Attack, Transient / etiology, therapy Male Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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