Document Detail

Inadequate cerebral perfusion is an unlikely cause of perioperative stroke.
MedLine Citation:
PMID:  9181763     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to determine the importance of hypoperfusion ischemia as a cause of stroke during carotid endarterectomy (CEA). A retrospective analysis of 128 consecutive CEA procedures were examined in patients at risk for hypoperfusion ischemia, namely, patients with occlusion of the contralateral carotid artery. All procedures were performed under general anesthesia without the use of a temporary indwelling shunt. Sixty-one percent of patients had cerebrovascular symptoms preoperatively and 39% were asymptomatic. The degree of stenosis of the carotid artery was 80%-99% in 67% (86/128) of patients, 60%-79% in 25% (32/128), 20%-59% in 7% (9/128), and 0-19% in 0.8% (1/128). The perioperative mortality was 0.8% (1/128), the incidence of permanent neurologic morbidity was 1.6% (2/128), and the incidence of transient neurologic morbidity was 3.9% (5/128). In conclusion, these data suggest that hypoperfusion ischemia is a rare cause of stroke during CEA even in patients with occlusion of the contralateral carotid artery and that CEA can be performed safely even in patients with contralateral occlusion without the use of a temporary indwelling shunt.
E G Whitney; C M Brophy; E M Kahn; D G Whitney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  11     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-06-11     Completed Date:  1997-06-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  109-14     Citation Subset:  IM    
Department of Surgery, Medical College of Georgia, Augusta 30912, USA.
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MeSH Terms
Arteriosclerosis / pathology,  surgery
Brain Ischemia / etiology
Carotid Stenosis / pathology,  surgery
Cerebrovascular Circulation
Cerebrovascular Disorders / etiology*,  physiopathology
Endarterectomy, Carotid / adverse effects*
Intraoperative Complications
Postoperative Complications
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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