| Excimer laser-assisted high-flow extracranial/intracranial bypass in patients with symptomatic carotid artery occlusion at high risk of recurrent cerebral ischemia: safety and long-term outcome. | |
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MedLine Citation:
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PMID: 12364737 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: The goal of this study was to determine safety and long-term outcome of the excimer laser-assisted high-flow extracranial/intracranial (EC/IC) bypass in patients with symptomatic carotid artery occlusion (CAO) at high risk of recurrent stroke. METHODS: In a prospectively collected cohort of 103 patients with symptomatic CAO, 15 patients were selected for excimer laser-assisted EC/IC bypass surgery on the basis of predefined selection criteria: (1) transient or moderately disabling symptoms of focal cerebral ischemia, not symptoms of the retina only; (2) continuing symptoms after documentation of the CAO; (3) evidence of a possible hemodynamic origin of symptoms; and (4) informed consent of the patient. RESULTS: Eleven patients underwent the operation without complications One patient had a severely disabling stroke (Rankin grade 4) 11 days after the operation; the bypass was found occluded on reoperation. Two other patients had a moderately disabling stroke (Rankin grade 3) immediately after the operation. One patient died of myocardial infarction 1 day after surgery. Median follow-up time was 27 months. Of the 11 patients who underwent the operation without complications, 1 died 17 months after the operation of a brainstem stroke, and another patient had a new stroke ipsilateral to his CAO 10 months after the operation but without a change in Rankin grade. CONCLUSIONS: The excimer laser-assisted high-flow EC/IC bypass operation is a potentially promising procedure in patients with symptomatic CAO and a presumably high risk of recurrent stroke, but the procedure carries a definite risk. This risk is probably related not only to the procedure itself but also to the selection of patients. |
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Authors:
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Catharina J M Klijn; L Jaap Kappelle; Albert van der Zwan; Jan van Gijn; Cornelis A F Tulleken |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 33 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-10-04 Completed Date: 2002-11-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 2451-8 Citation Subset: IM |
Affiliation:
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University Department of Neurology, University Medical Center Utrecht, and the Rudolf Magnus Institute of Neurosciences, Utrecht, The Netherlands. c.j.m.klijn@neuro.azu.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon, Laser-Assisted* / adverse effects, methods Brain Ischemia / prevention & control* Carotid Artery Diseases / surgery* Cerebral Angiography Cerebral Revascularization / adverse effects, instrumentation*, methods* Cohort Studies Female Fibrinolytic Agents / therapeutic use Humans Male Middle Aged Patient Selection Prospective Studies Recurrence / prevention & control Risk Stroke / etiology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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