Document Detail


Long-term follow-up of reoperative carotid surgery.
MedLine Citation:
PMID:  10527438     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined our long-term results of carotid reoperation to identify risk factors for morbidity and secondary recurrence. METHODS: Medical record review revealed 27 patients had reoperative surgery for recurrent stenosis. Demographics, operative details, pathology, clinical outcome, and follow-up imaging results were reviewed. RESULTS: No neurologic deficits and no mortalities were noted perioperatively. Long-term follow-up (average 54 months) revealed an 85% 5-year and 29% 10-year estimated survival. The 5- and 10-year estimated neurologic event rates were 15% and 35%, respectively. These included 3 ipsilateral strokes and 1 ipsilateral TIA; only the TIA involved secondary restenosis. Follow-up imaging revealed a 21% incidence of secondary restenosis, occurring more frequently in patients with hyperlipidemia (P < 0.05) and previous contralateral endarterectomy (P < 0.05). CONCLUSIONS: (1) Reoperation provides long-term protection from stroke due to recurrent stenosis. (2) Secondary restenosis rates appear higher than those for primary surgery. (3) Hyperlipidemia and contralateral endarterectomy are risk factors for secondary restenosis.
Authors:
E D Dillavou; M B Kahn; R A Carabasi; S N Smullens; P J DiMuzio
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  178     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-04     Completed Date:  1999-11-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  197-200     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Jefferson Medical College, Philadelphia, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Stenosis / epidemiology,  surgery*
Endarterectomy, Carotid* / statistics & numerical data
Female
Follow-Up Studies
Humans
Hyperlipidemias / epidemiology
Incidence
Ischemic Attack, Transient / epidemiology
Male
Middle Aged
Recurrence
Reoperation / statistics & numerical data
Risk Factors
Stroke / prevention & control*
Survival Rate
Time Factors

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


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