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ORIGINAL ARTICLE  VASCULAR SECTION Open accessopen access

The Journal of Cardiovascular Surgery 2022 December;63(6):695-9

DOI: 10.23736/S0021-9509.22.12321-9

Copyright © 2022 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.

lingua: Inglese

Long-term functional consequences of cranial nerve injuries after carotid endarterectomy

Mahia AIVAZ IHARI 1, 2 , Lars ANDERSSON 1, Tony LUNDH 3, 4, Joakim NORDANSTIG 1, 2, Sofia STRÖMBERG 1, 2, Annika NORDANSTIG 3, 4

1 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2 Department of Molecular and Clinical Medicine, University Hospital of Sahlgrenska, Gothenburg, Sweden; 3 Department of Clinical Neurosciences, Institute of Neurosciences and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 4 Department of Neurology, University Hospital of Sahlgrenska, Gothenburg, Sweden



BACKGROUND: The aim of the study was to investigate long-term patient consequences of cranial nerve injury (CNI) caused by carotid endarterectomy (CEA) in patients with identified CNI at the 30-day follow-up.
METHODS: Consecutive patients operated for symptomatic carotid artery stenosis 2015-2019 with a documented CNI at the 30-day follow-up after CEA were recruited to this cross-sectional survey. Telephone interviews were conducted >1 year after CEA utilizing survey instruments developed to uncover CNI symptoms. Patients graded their symptoms on a 4-point scale: 1) no symptoms; 2) mild symptoms; 3) moderate symptoms; and 4) severe symptoms.
RESULTS: Altogether, 477 patients underwent CEA, of which 82 were diagnosed with CNI; 70/82 patients remained alive at the time for the survey and 68 patients completed the interview. The mean follow-up time was 3.7 years. Severe persistent CNI symptoms were reported in 2/68 (2.9%), moderate symptoms in 1/68 (1.5%) and mild symptoms in 14/68 (21%) whereas 51/68 patients (75%) reported no residual symptoms. When extrapolating these findings to all patients, approximately 4.4% reported persistent symptoms at the long-term follow-up and only 0.8% reported moderate or severe symptoms.
CONCLUSIONS: The long-term consequences of CNI following CEA are benign in most patients, with a high rate of symptom resolution and a very low rate of persistent clinically significant symptoms.


KEY WORDS: Cranial nerve injuries; Endarterectomy, carotid; Carotid stenosis

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