Document Detail


Long-term Morbidity and Mortality of Carotid Endarterectomy in Patients with End-stage Renal Disease Receiving Hemodialysis.
MedLine Citation:
PMID:  23830959     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Renal insufficiency is a known risk factor for stroke. However, the impact of carotid endarterectomy (CEA) on stroke incidence in patients requiring dialysis remains controversial. We hypothesized that patients undergoing dialysis have no greater risk for periprocedural adverse events.
METHODS: We performed a retrospective chart review of 12 CEA patients who were on dialysis at the time of CEA. The charts were reviewed for patient demographics, systemic vascular disease, perioperative morbidity and mortality rates, and long-term outcome. Outcomes were recorded in terms of modified Rankin Scale (mRS).
RESULTS: The mean patient age at the time of CEA was 66.9 ± 7.3 years, with 1 patient having received carotid artery stenting for restenosis. Of the 12 patients undergoing 15 CEAs while being dialysis dependent, none exhibited periprocedural complications including stroke and myocardial infarction. During the follow-up period (mean, 56.1 ± 38.8 months), 3 patients had strokes unrelated to the target vessels for CEA, and 3 patients died from acute myocardial infarction, congestive heart failure, and sepsis. The calculated 5-year survival rate in our series was 58.3% in all cases, 40.0% in symptomatic patients, and 71.4% in asymptomatic patients. Eight patients (66.6%) had a good outcome.
CONCLUSIONS: These data suggest that patients undergoing dialysis were at no greater risk for periprocedural complications when undergoing CEA. Thus, CEA may be effective for stroke prevention in hemodialysis patients.
Authors:
Masakazu Okawa; Tetsuya Ueba; Toshiyasu Ogata; Hiroshi Abe; Toshio Higashi; Tooru Inoue
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-7-4
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  -     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-7-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. Electronic address: okawam@fukuoka-u.ac.jp.
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