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THE 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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ORIGINAL ARTICLES VASCULAR SECTION
The Journal of Cardiovascular Surgery 2007 Ottobre;48(5):587-91
Results of carotid re-exploration for post-carotid endarterectomy thrombosis
Hans S. S.
Department of Surgery St. John Macomb Hospital Warren, MI USA
Aim. Evaluate the results of carotid re-exploration for post-carotid endarterectomy (CEA) thrombosis associated with major neurological deficit.
Methods. Data obtained from ongoing vascular registry. Retrospective analysis of 2216 consecutive CEAs performed in a single surgical practice.
Results. New neurological deficits developed in 53 patients (2.4%) following CEA. Fourteen patients sustained intraoperative stroke. Of 33 patients with postoperative stroke, nine patients had mild neurological deficit. Of the remaining 24 patients with postoperative stroke, five experienced intracerebral hemorrhage, three had strokes unrelated to operated artery, and one had stroke following control of bleeding from CEA patch disruption. The remaining 15 patients developed a significant neurological deficit following CEA and underwent re-exploration for postoperative carotid thrombosis. Five patients had minimal neurological improvement, five patients showed moderate recovery, and the remaining five patients had near complete recovery.
Conclusion. Prompt re-exploration for post CEA thrombosis associated with major stroke can result in satisfactory outcome in majority of patients.