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Paper Information

Journal:   RESEARCHER BULLETIN OF MEDICAL SCIENCES (PEJOUHANDEH)   2004 , Volume 9 , Number 2 (38); Page(s) 71 To 76.
 
Paper: 

STUDY OF PERI, INTERA, POST OPERATIVE AND LONG TERM FOLLOW UP OF CAROTID END ARTERECTOMY IRANMEHR HOSPITAL

 
 
Author(s):  SALEHIAN M.T., NIKOUMARAM B., FAZEL I., VALAEI NASER
 
* 
 
Abstract: 

Background: To evaluate early and late results of carotid endarterectomy (CEA) and the rate of recurrent carotid stenosis after the surgery, this study was done on the patients admitted at the Iran-Mehr hospital between 1991 and 2001.
Materials and methods: In a cross sectional study, data of all the patients who underwent CEA, including indication, age, sex, preoperative angiogram and duplex scans, underlying medical illness, technique of carotid closure and immediate postoperative complications, were collected. The long-term follow-up results and the recurrence of the stenosis assessed by duplex scan were recorded and the impacts of various risk factors on the development of recurrent stenosis were assessed statistically.
Results: During the study a single surgical team on 197 patients performed 212 consecutive CEA. The mean age of the patients was 66.2±8.5 years and 132 (67%) were male. Indication for surgery were Transient Ischemic Attack (TIA) 139 (65.6%); Reversible Ischemic Neurological deficit (RIND) 35 (16.5%); recovered stroke 26(12.3%); Amaurosis fugax 10 (4.7%); and symptom free high-grade stenosis 3 (1.9%) respectively. The technique emphasized routine general anesthesia and routine use of intra-operative shunt. The artery was closed primarily in 61(35.8%) cases and with a patch in 136 (64.2%). Complications include 3 (1.4%) death, 3 (1.4%) strokes, 3 (1.4%) wound hematoma and one recovered phonation disturbance. At long-term clinical follow-up one TIA and one carotid artery psuedoaneurysm was observed. Duplex scan follow-up were performed on 67 patients who 11(10.9%) of them identified with recurrent symptom free stenosis above 50%. Only coronary artery diseases were associated with an increased risk of restenosis (odds ratio, 8.2; 95% confidence interval, 1 to 73). None of the other factors including sex, diabetes mellitus, and chronic renal failure and using patch graft or simple closure influenced on restenosis.
Conclusion: Surgical management of symptomatic carotid stenosis is safe on the hand of experienced surgeon using the above techniques. Recurrent stenosis was seen with more frequency in patients with CAD. This may reflect the rapid progression of arterial occlusive disease in this group of patients.

 
Keyword(s): RECURRENT STENOSIS, AMAUROSIS, CEA, TIA, RIND, CAD
 
References: 
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