Selective external endarterectomy in patients with ipsilateral symptomatic internal carotid artery occlusion

Journal of Vascular Surgery
Margriet FokkemaGert Jan de Borst

Abstract

Selective endarterectomy of external carotid artery (ECA) stenosis has been considered a therapeutic option for patients presenting with symptomatic ipsilateral internal carotid artery (ICA) occlusion to correct cerebral hypoperfusion or eliminate a source of emboli. However, data are scarce, and the long-term benefit of ECA revascularization remains unclear. Our objective was to study the operative results and durability of selective ECA endarterectomy in patients presenting with cerebrovascular symptoms in association with nonacute ipsilateral ICA occlusion. This was a retrospective analysis of 27 consecutive patients who underwent selective ECA endarterectomy in a single center between 2000 and 2010. All patients presented with neurologic symptoms (<6 months of surgery, 78% repeat events) referable to an ipsilateral occlusion of the ICA and concomitant stenosis of the ECA. We assessed the perioperative clinical outcome <30 days and at midterm follow-up (mean, 31.6 months). Patency was defined as freedom of duplex ultrasound detected ≥ 50% restenosis. Endarterectomy of the ECA was successful in 26 patients (96.3%) with one ECA found occluded at surgery. No perioperative deaths occurred. In the 30 days after surgery, one patie...Continue Reading

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Citations

Aug 8, 2014·Journal of Neurointerventional Surgery·Eric SchmidtJustin F Fraser
Dec 3, 2014·Annals of Vascular Surgery·Jeffrey J SiracuseNicholas J Morrissey

Related Concepts

Internal Carotid Artery Structure
Cerebrovascular Occlusion
Myocardial Infarction
Relapse
Retrospective Studies
Vascular Patency
Survival Analysis
Internal Carotid Artery Stenosis
Carotid Endarterectomy
Ultrasonography, Doppler, Duplex

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