Document Detail


Surgical treatment of internal carotid artery occlusion.
MedLine Citation:
PMID:  12663978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Nonoperative treatment of recent internal carotid artery (ICA) occlusion is associated with increased recurrent stroke rates. We analyzed our results of carotid endarterectomy (CEA) for treatment of symptomatic recent ICA occlusion to evaluate its feasibility, safety, and outcomes.
METHODS: From 1990 to 2002, all patients with transient ischemic attack (TIA), amaurosis fugax, and minor stroke underwent duplex ultrasound (US) scanning and arteriography to confirm the diagnosis of ICA occlusion. Within 2 weeks of symptom onset, patients underwent operative exploration with attempted CEA. ICA occlusion was detected at preoperative angiography and confirmed at surgery. Patients with extensive ICA plaque not amenable to endarterectomy underwent external CEA with ICA ligation.
RESULTS: Over 12 years, 87 patients with symptomatic ICA occlusion underwent 90 operations for ICA exploration. In 30 patients (18 men, 12 women) with TIA (45%), amaurosis fugax (19%), or minor stroke (36%), CEA to treat ICA occlusion was technically successful. There was 1 postoperative stroke, 2 asymptomatic internal carotid occlusions, and no restenoses (mean follow-up, 26 months; range, 1-93 months). In 57 patients (37 men, 20 women) with TIA (41%), amaurosis fugax (27%), or stroke (32%) in whom CEA was unsuccessful, external CEA was performed. In this group there were no postoperative strokes, 2 asymptomatic external carotid artery occlusions, and 1 restenosis (>70%) (mean follow-up, 22 months; range, 1-73 months). There were no late strokes in either group.
CONCLUSION: Operative exploration and endarterectomy to treat symptomatic ICA occlusion is feasible and safe. Patients with symptomatic ICA occlusion should be considered candidates for CEA.
Authors:
Philip S K Paty; John A Adeniyi; Manish Mehta; R Clement Darling; Benjamin B Chang; Paul B Kreienberg; Kathleen J Ozsvath; Sean P Roddy; Dhiraj M Shah
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  37     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-28     Completed Date:  2003-05-09     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  785-8     Citation Subset:  IM    
Affiliation:
Institute for Vascular Health and Disease, Albany Medical College, NY 12208, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography
Carotid Artery, Internal*
Carotid Stenosis / diagnosis,  surgery*
Cerebrovascular Disorders / etiology
Endarterectomy, Carotid* / adverse effects,  mortality
Female
Humans
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Survival Analysis
Treatment Outcome
Ultrasonography, Doppler, Color

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


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