Carotid surgery in acute symptomatic patients
| Autor: | Rita Huber, B. T. Müller, Ulrich Mödder, Rüdiger J. Seitz, Wilhelm Sandmann, Mario Siebler |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Adult
Carotid Artery Diseases Male medicine.medical_specialty Time Factors Diagnostic criteria Hemodynamics Disease Carotid surgery Recurrent stroke medicine.artery medicine Humans Internal carotid artery reconstruction Prospective Studies Stroke Aged Aged 80 and over Medicine(all) Endarterectomy Carotid Ultrasonography Doppler Duplex business.industry Angiography Digital Subtraction Perioperative Middle Aged Cerebral ischemia University hospital medicine.disease Magnetic Resonance Imaging Survival Analysis Stroke unit Surgery Urgent carotid surgery Treatment Outcome Acute Disease Middle cerebral artery Female Radiology Cardiology and Cardiovascular Medicine business Carotid Artery Internal Magnetic Resonance Angiography |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. (1):60-67 |
| ISSN: | 1078-5884 |
| DOI: | 10.1053/ejvs.2002.1774 |
| Popis: | Objectives: evaluation of urgent carotid artery surgery with new diagnostic techniques and changing surgical considerations at a university hospital. Design, material and methods: prospective monitoring and assessment of outcome in 67 patients who underwent urgent carotid surgery because of symptomatic extracranial carotid artery involvement. Patients were examined via the stroke unit: duplex sonography was mandatory for diagnosis of extracranial carotid artery disease, as was proof of an open middle cerebral artery (MCA). Assessment of intracerebral damage followed CT or MR imaging procedures. Perioperative and surgical management was standardized. Neurological impairment was assessed pre-, postoperatively and at follow-up using the Rankin scale. “Urgent” was defined as “immediate” after the final diagnostic step had been performed. Results: within a period of 26 months 67 symptomatic patients (58% stroke, 42% TIA) underwent urgent carotid surgery. Median time from admission to surgery was 2 days. In all but five cases flow through the ICA could technically be restored (93%). Thirty-day mortality was 3% and disease-related morbidity 13%. The one and two year survival rates were 92 and 90%, respectively. No ipsilateral recurrent stroke occurred during follow-up. Conclusions: clinical decision-making based on stratified diagnostic workup by means of extra- and intracranial as well as intracerebral hemodynamics using new imaging techniques may select patients who will benefit more from urgent surgery than from conservative management. Eur J Vasc Endovasc Surg 25, 60–67 (2003) |
| Databáze: | OpenAIRE |
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