What is the clinical evidence from this study?

Study design: Cohort. Population: Cervical carotid artery stenosis (n=63). Intervention: Carotid endarterectomy. Primary outcome: Perioperative complications.

What question did this study set out to answer?

To evaluate perioperative complications, causes of ischemic events, and long-term outcomes in patients undergoing microsurgical carotid endarterectomy.

January 1, 1994Surgery for Cerebral StrokeOpen Access

Ischemic Complications and Late Prognosis of Carotid Endarterectomy

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Key result

Carotid endarterectomy is associated with an ~10% perioperative complication rate in cervical carotid artery stenosis.

n=63

Population

63 patients with cervical carotid artery stenosis undergoing 73 carotid endarterectomies

Design

Case_series

Follow-up

mean 24.5 months

Authors

SKSatoshi KurodaTokai University Hachioji Hospital HKHiroyasu KamiyamaHokkaido University of Science KHKiyohiro HoukinHokkaido University

Discussion

Member takes

Implication

These rates in a small single-center series should not alter practice; leaves open the need for prospective comparisons of microsurgical CEA techniques.

Key Points

To evaluate perioperative complications, causes of ischemic events, and long-term outcomes in patients undergoing microsurgical carotid endarterectomy.
Reviewed 73 carotid endarterectomies performed across 63 patients with cervical carotid artery stenosis over a 6-year period.
Utilized microsurgical technique supported by internal shunts alongside continuous electrophysiological monitoring with EEG and somatosensory evoked potentials.
Assessed perioperative adverse events and tracked long-term neurological and cardiovascular outcomes over a mean follow-up of 24.5 months.
Perioperative complications occurred in 7 of 73 procedures (9.6%), consisting of cerebral infarction (n=4), transient hypoglossal nerve palsy (n=1), acute hepatitis (n=1), and pneumonia (n=1).
Transient internal shunt obstruction caused thromboembolism resulting in major neurological deficits in 2 patients, whereas hemodynamic ischemia in severe stenosis caused minor or no deficits in 2 patients.
During mean follow-up, 4 patients (5.5%) developed late cerebral infarction (3 ipsilateral, 1 vertebrobasilar) and 1 patient died of myocardial infarction.

Study Design

Type

Cohort (n=63)

Multicenter

Yes

Structured PICO

Population

63 patients (mean age 55.0 years, 11.1% female) with cervical carotid artery stenosis who underwent 73 carotid endarterectomies, followed for a mean of 24.5 months.

Intervention

Microsurgical carotid endarterectomy with internal shunts and electrophysiological monitoring (EEG and somatosensory evoked potentials)

Outcome

Perioperative complications and late prognosis (cerebral infarction, death)hard clinical

Microsurgical carotid endarterectomy is associated with a 9.6% perioperative complication rate, emphasizing the importance of strategies to prevent perioperative cerebral infarction.

Limitations

Retrospective design
Small sample size
Lack of a control group

Cite This Study

Kuroda et al. (1994) conducted a cohort in Cervical carotid artery stenosis (n=63). Carotid endarterectomy was evaluated on Perioperative complications. Among patients with cervical carotid artery stenosis, carotid endarterectomy was associated with a 9.6% rate of perioperative complications and a 5.5% rate of late cerebral infarction over a mean follow-up of 24.5 months.

synapsesocial.com/papers/6aa4e91772bda1c777aa227f https://doi.org/10.2335/scs1987.22.1_9

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Implication

These rates in a small single-center series should not alter practice; leaves open the need for prospective comparisons of microsurgical CEA techniques.

Ischemic Complications and Late Prognosis of Carotid Endarterectomy

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Ischemic Complications and Late Prognosis of Carotid Endarterectomy

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider