ORIGINAL ARTICLES   

Minerva Cardioangiologica 1999 April;47(4):121-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Neurological complications in carotid endarterectomy

Garofalo M., Borioni R., Albano P., Nardi P., Colagrande L., Seddio F., Scafuri A., Chiariello L.

Background and aims. Carotid endarterectomy (CEA) is often carried out to prevent cerebrovascular strokes. It is obviously important that neurological morbidity of the procedure is contained within acceptable limits (<2%).
Methods. Between January 1991 and December 1997 a total of 239 CEA were performed in 216 patients (169 males and 47 females, mean age 66.6±14.2 years; range 43-81). Angioplasty was carried out using a precoagulated Dacron patch, except in cases in which the residual diameter of the internal carotid artery was greater than 5 mm. A Javid shunt was used selectively if stump pressure <50 mmHg.
Results. No major neurological complications were observed. A reversible focal neurological deficit was reported in 3 cases (1.2%).
Neurological morbidity correlated to peripheral arterial occlusive disease appears to be correlated mainly with technical reasons or cerebral ischemia following clamping.
Conclusions. The extensive use of angioplasty with patch and the selective use of a protective shunt improve the technical success rate of surgery, significantly helping to limit morbidity.