Is carotid endarterectomy justified in patients with severe chronic renal insufficiency?

Annals of Vascular Surgery
E E RigdonR S Rhodes

Abstract

We evaluated the effect of chronic renal insufficiency (CRI) and commonly associated co-morbid conditions on the risk of adverse events (stroke, cardiac events, and death) within 30 days after carotid endarterectomy (CEA). Renal function of patients undergoing CEA from 1980 to 1994 was categorized as normal (creatinine < 1.5 mg/dl), mild CRI (creatinine 1.5-2.9 mg/dl), or severe CRI (creatinine > 2.9 mg/dl). Renal function, age, gender, indications for surgery, cardiac disease, chronic preoperative hypertension, diabetes mellitus, smoking history, severe perioperative hypertension or hypotension, intraoperative shunting, and patch closure of the carotid artery were evaluated for their influence on the incidence of adverse events within 30 days after surgery. The timing of postoperative stroke and mechanism of stroke was determined when possible. A total of 237 patients underwent 285 CEAs. No significant differences were found in demographic or clinical characteristics between patients with normal or abnormal renal function. Postoperative stroke and death occurred following three (43%) of seven CEAs in six patients with severe CRI, significantly greater than the 6% incidence of stroke and 1% mortality following 264 CEAs in 221 p...Continue Reading

Citations

Feb 8, 2005·Journal of Vascular Surgery·Enrico AscherAnil P Hingorani
Dec 16, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·William A GrayRichard Green
Jun 3, 2006·Annals of Vascular Surgery·Erik Debing, Pierre Van den Brande
Sep 15, 2006·Current Surgery·Ahmad TarakjiGary G Nicholas

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