Long-term outcomes of axillary to carotid bypass for symptomatic patients with chronic common carotid artery occlusion
| Autor: | Xunming Ji, Jian Zhang, Yong Quan Gu, Heng Xi Yu, Li Po Song, Chunmei Wang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry Retrospective cohort study Perioperative 030204 cardiovascular system & hematology medicine.disease Surgery law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine.artery Occlusion medicine 030212 general & internal medicine Myocardial infarction Common carotid artery Cardiology and Cardiovascular Medicine business Brachial plexus Stroke |
| Zdroj: | Journal of Vascular Surgery. 72:597-602 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2019.10.059 |
| Popis: | Objective Relatively little is known about the natural history of atherosclerotic common carotid artery occlusion and optimal treatment of these patients is still unclear. The aim of this retrospective study was to evaluate the immediate- and long-term outcomes of axillary to carotid bypass with polytetrafluoroethylene graft for symptomatic patients with chronic common carotid artery occlusion. Methods From March 2001 to December 2017, 58 symptomatic patients (41 men; mean age 64.7 years) with chronic common carotid artery occlusion underwent axillary to carotid bypass at one academic hospital. The clinical data of this patient cohort were retrospectively analyzed. The cumulative graft patency, overall survival, freedom from symptoms, and freedom from ipsilateral stroke were calculated with Kaplan-Meier method. Results Thirty-three patients presented with transient ischemic attack and 25 patients presented with minor stroke. At 30 days after bypass, the overall perioperative complication rate was 3.4% (2/58). Mild injuries of brachial plexus occurred in one (1.7%) patient and myocardial infarction occurred in one (1.7%) patient. No perioperative stroke or death occurred. The median follow-up was 51 months (range, 12-203) for this series. The cumulative graft patency rates at 1, 3, 5, and 10 years were 100%, 100%, 94%, and 83%, respectively. The cumulative freedom from symptoms rates at 1, 3, 5, and 10 years were 100%, 100%, 94%, and 75%, respectively. The cumulative freedom from ipsilateral stroke rates at 1, 3, 5, and 10 years were 100%, 100%, 94%, and 82%, respectively. The overall survival rates at 1, 3, 5, and 10 years were 98%, 89%, 81%, and 67%, respectively. Conclusions Axillary to carotid bypass with polytetrafluoroethylene graft is safe and durable for symptomatic patients with chronic common carotid artery occlusion. The results of this study should be confirmed with a larger, randomized controlled trial in future. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|