Sites of recurrence and long-term results of redo surgery

Annals of Surgery
B A BallingerJ L Ochsner

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

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Citations

Nov 15, 2002·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Ali F AbuRahmaPatrick A Stone
Dec 18, 2007·Annals of Vascular Surgery·Amir H DorafsharWesley S Moore
Jan 5, 2013·The British Journal of Surgery·K BekelisN Labropoulos
Dec 25, 2007·Journal of Vascular Surgery·Gert J de BorstFrans L Moll
Mar 23, 2010·Journal of Vascular Surgery·Raphaël CoscasFabien Koskas
Jan 14, 2004·Journal of Vascular Surgery·Jae-Sung ChoDaniel J Reddy
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

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