PMID: 8601883Mar 1, 1996Paper

Carotid endarterectomy without a shunt for symptomatic lesions associated with contralateral severe stenosis or occlusion

Journal of Vascular Surgery
J E FrawleyJ W Niesche

Abstract

The purpose of this study was to assess the adequacy of thiopental protection against ischemic cerebral damage in patients undergoing carotid endarterectomy for symptomatic stenosis greater than 70% in association with contralateral stenosis greater than 70% or contralateral occlusion. All patients (n=259) with severe bilateral carotid disease who underwent carotid endarterectomy for symptomatic stenosis greater than 70% were extracted from the database of an ongoing prospective carotid surgery study. Large-dose thiopental sodium without shunting was used for cerebral protection during endarterectomy. Asymmetric electroencephalogram changes during the operation, carotid occlusion time, stroke onset, and neuropathologic outcomes were analyzed. Three contralateral strokes occurred in the series, producing a cerebral morbidity/mortality rate of 1.2% (major 0.4%, minor 0.8%). Transient morbidity was 1.9% made of two reversible ischemic neurologic deficits and three transient ischemic attacks. New asymmetric electroencephalography changes were seen in 49 (19% patients, one of whom had transient deficit. Average occlusion time was 35 minutes. All strokes occurred within 24 hours of the procedure. Patients with previous stroke and and...Continue Reading

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Citations

Feb 24, 2001·Scandinavian Cardiovascular Journal : SCJ·H ZachrissonR Volkmann
Sep 24, 2015·Medical Science Monitor Basic Research·Anastasios PapapetrouSotiris Georgopoulos
Dec 16, 2005·Neurological Research·Miguel A MelgarMartin Weinand
Feb 24, 2015·International Journal of Vascular Medicine·Laura CapocciaFrancesco Speziale
May 4, 2013·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·G FaggioliA Stella
Oct 22, 2003·Annals of Vascular Surgery·Christoph DomenigFrank B Pomposelli
Nov 19, 2002·São Paulo Medical Journal = Revista Paulista De Medicina·Kenji NishinariLuiz Paulo Kowalski
Mar 14, 2007·Annals of Vascular Surgery·Ilias DalainasDomenico G Tealdi
Mar 22, 2002·ANZ Journal of Surgery·Sandy MiddletonUNKNOWN New South Wales Carotid Endarterectomy Audit Project Working Group
Jul 15, 2018·Asian Cardiovascular & Thoracic Annals·Aram BaramAllaa Subhi Abdel-Majeed
Apr 12, 2013·Journal of the Korean Surgical Society·Jayun ChoSeung Huh
Feb 19, 2020·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Damianos G KokkinidisEhrin J Armstrong
Oct 24, 2001·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·D M LamanA C van Huffelen

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