Abstract
The authors determined whether carotid endarterectomy in patients with recurrent stenosis could provide durable stroke prevention with acceptable perioperative risk. Balloon angioplasty and stenting are being advocated for recurrent stenosis because of the presumption that reoperation is unsafe with poor results. The authors retrospectively reviewed their experience with 67 patients undergoing 74 operations for recurrent stenosis in a recent 11-year period. This represented 8.4% of 883 endarterectomies performed during the same period. At original operation, 55% had primary closure and 45% were patched. Reoperation was performed for amaurosis fugax and transient ischemic attack (45%), post-stroke (7%), global ischemia (10%), and asymptomatic severe occlusive disease (35%). Four patients (6%) undergoing simultaneous cardiac procedures were excluded from further analysis. Mean duration between primary and first redo operation was 78 months (range, 1-240 months). The 30-day combined mortality and stroke morbidity was 2.8%, evenly divided with 1.4% stroke and 1.4% mortality rates. Recurrent disease occurred predominantly (69%) in the previous endarterectomy site. Follow-up ranged from 1 to 162 months (mean, 48.2). Seventeen deaths ...Continue Reading
References
Jun 1, 1992·Journal of Vascular Surgery·W K WashburnT F O'Donnell
Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Jan 1, 1991·Journal of Vascular Surgery·R S NitzbergA D Callow
Nov 1, 1990·Annals of Surgery·E F BernsteinR B Dilley
Nov 1, 1988·American Journal of Surgery·A KazmersH M Radke
Jun 1, 1986·Annals of Surgery·R W BarnesB T Nichols
May 10, 1995·JAMA : the Journal of the American Medical Association
May 1, 1995·Annals of Surgery·K A CoyleA B Lumsden
Aug 1, 1994·American Journal of Surgery·A F AbuRahmaD J Patton
May 1, 1996·Journal of Vascular Surgery·R E CarballoR A Cambria
Aug 14, 1996·The American Journal of Cardiology·G S RoubinJ Vitek
Aug 1, 1996·Journal of Vascular Surgery·T F O'DonnellW C Mackey
Feb 1, 1996·Journal of Endovascular Surgery : the Official Journal of the International Society for Endovascular Surgery·E B DiethrichD B Reid
Citations
Nov 15, 2002·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Ali F AbuRahmaPatrick A Stone
Feb 18, 2014·Annals of Vascular Surgery·A George AkingbaJeffrey Rubin
Dec 18, 2007·Annals of Vascular Surgery·Amir H DorafsharWesley S Moore
Jan 5, 2013·The British Journal of Surgery·K BekelisN Labropoulos
Apr 5, 2015·Surgery·Jian TuShenming Wang
Dec 25, 2007·Journal of Vascular Surgery·Gert J de BorstFrans L Moll
Mar 23, 2010·Journal of Vascular Surgery·Raphaël CoscasFabien Koskas
Mar 10, 2001·Journal of Vascular Surgery·J P Archie
Jan 14, 2004·Journal of Vascular Surgery·Jae-Sung ChoDaniel J Reddy
Jan 12, 1999·Journal of Vascular Surgery·C B RockmanG R Jacobowitz
Mar 20, 2009·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·P SapienzaA Cavallaro
Sep 5, 2006·Journal of Vascular Surgery·Craig R Narins, Karl A Illig
Aug 25, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Bernhard ReimersAnnalisa Angelini
Jul 8, 1999·Journal of Vascular Surgery·B B HillC K Zarins
Oct 20, 1999·American Journal of Surgery·E D DillavouP J DiMuzio
Oct 22, 2003·Annals of Vascular Surgery·Christoph DomenigFrank B Pomposelli
Dec 16, 2004·Vascular and Endovascular Surgery·Ahmed M Abou-ZamzamJohn M Porter
Dec 12, 2001·Stroke; a Journal of Cerebral Circulation·A F AbuRahmaP A Robinson