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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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The Journal of Cardiovascular Surgery 1999 Dicembre;40(6):849-55

VASCULAR PAPERS 

 ORIGINAL ARTICLES

Carotid endar­te­rec­to­my with­out pro­tec­tive meas­ures in ­patients ­with occlud­ed and non occlud­ed con­tralat­er­al carot­id ­artery

Dimakakos P. B., Antoniou A.*, Papasava M., Mourikis D.*, Rizos D.°

From the Department of Vascular Surgery 2nd Surgical Clinic
*Department of Radiology
°Department of Hormonology and Biostatistics “Aretaeion” Hospital, University of Athens, Greece

Background. Comparison of carotid endar­te­rec­to­my in ­patients ­with and with­out occlud­ed con­tra­lat­er­al carot­id ­artery.
Methods. Design: evaluation of ­results with­out ­using ­shunt or ­patch. Setting: «Aretaeion» Hospital, Medical School, University of Athens. Subjects: 235 ­patients, divid­ed ­into ­group I of 40 ­patients ­with and ­group II of 195 ­patients with­out occlud­ed con­tra­lat­er­al carot­id ­artery. Intervention: carotid endar­te­rec­to­my ­under gen­er­al anes­the­sia. Main out­come meas­ures: heparin admin­is­tra­tion, ­stable hemo­dy­nam­ic stat­us dur­ing clamp­ing, ­short dura­tion mon­i­tor­ing post­op­er­a­tive­ly.
Results. Postoperative mor­bid­ity of ­both ­groups was 2.5% (6/235) and mor­tal­ity 1.7% (4/235). Group I: mor­tal­ity ­rate was 2.5% (1/40) ­major and ­minor ­stroke ­each 2.5% (1/40) and ­group II: 1.5% (3/195) and 1% (2/195) respec­tive­ly (NS). Four to 108 ­months lat­er, 30% (12/40) of group I and 21% (41/195) of group II ­died.
Conclusions. Endarterectomy of the carot­id ­artery ­under gen­er­al anes­the­sia with­out use of ­shunt and ­patch in ­patients ­with or with­out occlu­sion of the con­tra­lat­er­al carot­id ­artery pre­sent­ed the ­same com­par­a­tive ­results. Candidates for carot­id endar­te­rec­to­my ­should be ­screened system­at­i­cal­ly for cor­o­nary dis­ease pre­op­er­a­tive­ly and annu­al ­stress test­ing post­op­er­a­tive­ly, tac­tics ­which may ­improve ear­ly and ­late mor­tal­ity ­rate ­after carot­id sur­gery.

lingua: Inglese


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