Carotid endarterectomy without a shunt: The control series
| Autor: | Fred N. Littooy, Andrew C. Hayes, William H. Baker, Douglas B. Dorner, David H. Stubbs |
|---|---|
| Rok vydání: | 1984 |
| Předmět: |
medicine.medical_specialty
business.industry Neurologic complication medicine.medical_treatment Single factor Statistical difference Carotid endarterectomy CAROTID OCCLUSION Shunt (medical) Surgery Clamp Internal medicine medicine.artery cardiovascular system Cardiology Medicine cardiovascular diseases Internal carotid artery business Cardiology and Cardiovascular Medicine |
| Zdroj: | Journal of Vascular Surgery. 1:50-56 |
| ISSN: | 0741-5214 |
| DOI: | 10.1067/mva.1984.avs0010050 |
| Popis: | Nine hundred forty carotid endarterectomies were performed without the use of a temporary indwelling shunt. Six patients (0.6%) died, all from stroke; 17 other patients (1.8%) had another stroke, and 21 patients (2.2%) had temporary neurologic symptoms. Complete x-ray films detailing the opposite internal carotid artery and carotid artery back pressure were available for 783 operations. Correlation of stroke to back pressure, status of the contralateral internal carotid artery, preoperative neurologic deficit, and carotid clamp time was examined. Statistical analysis demonstrated significantly increased neurologic complications only if the systolic carotid back pressure was ≤50 mm Hg or the contralateral internal carotid artery was occluded. Analysis to determine if these factors were dependently related showed that when both a contralateral carotid occlusion and a carotid back pressure of ≤50 mm Hg coexisted (82 patients), the rate of permanent deficit was 11.0% compared with 2.8% when either factor was singly present and 0.9% when neither factor was present. No statistical difference exists between the group with only a single factor and those with neither factor. When a temporary shunt is not used during carotid endarterectomy, the risk of neurologic complication is increased if both a contralateral internal carotid artery occlusion and a carotid back pressure of ≤50 mm Hg coexist. The use of a shunt in this patient population may be beneficial. (J VASC SURG 1984;1:50-56.) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|