Comparative Results of Staged and Simultaneous Bilateral Carotid Endarterectomy: A Clinical Study and Surgical Treatment

Objective: Bilateral carotid stenoses are actually managed by staged endarterectomy. The present study compares the results of the above surgical procedure with simultaneous bilateral carotid endarterectomy. Methods: Sixty-four carotid endarterectomies were carried out on two groups of thirty-two patients with bilateral carotid stenoses. Fifteen patients (group A) were subjected to staged and 17 patients (group B) who were subjected to simultaneous bilateral carotid endarterectomies. Results: The mortality rate was zero in both groups; no statistically significant difference was found concerning complications related to the heart, neurological deficit and postoperative hypertension. Conclusions: Simultaneous carotid endarterectomy is a challenging and technically demanding operation but with limited indications in strictly selected patients. The development of methods of more effective monitoring and protection of the cerebral cells might broaden the indications of such a surgical tactic in the future. Staged carotid endarterectomy, however, remains the method of choice for the management of bilateral carotid occlusive disease.