Endarterectomy of the Totally & Subtotally Occluded Carotid Artery Facilitates the Surgery of the Stenosed Contralateral Side
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2016, Vol 15, Issue 7
Abstract
Purpose: Patients with one side total/subtotal occlusion and contralateral side critical stenosis are high risk candidates for carotid interventions for the stenosed carotid side. We present our experiences with carotid endarterectomy of the stenosed side after revascularization of the occluded side. Methods: Between March 2010 and September 2013, 85 carotid endarterectomies were performed in seventy-four patients. Among the patients, 6 had one side total/subtotal occlusion and contralateral side 70% carotid stenosis. Patients received revascularization for the occluded side first followed by of the endarterectomy of the contralateral stenosed part. Results: Four patients had cerebrovascular symptoms ipsilateral to the occluded side. Operations were performed with local anesthesia. Endarterectomy priority was given to the occluded side which was followed by the endarterectomy of the contralateral side after 17.24.6 days. No neurologic deficit occured during the surgeries and shunt was not required. Mortality did not occur and patients are followed a mean of 18.46.3 months event free. Conclusion: Endarterectomy of the stenosed carotid artery contralateral to the totally/subtotally occluded side is challenging and carries high risk. The treatment of the occluded side first facilitates the endarterectomy of the contralateral carotid stenosis.
Authors and Affiliations
Murat Ugurlucan, Muslum Ercument Filik, Ertugrul Zencirci, Gamze Babur Guler, Ekrem Guler, Metin Onur Beyaz, Didem Melis Oztas, Omer Ali Sayin, Gabriele Piffaretti, Fatma Nihan Turhan Caglar, Mehmet Buget, Ufuk Alpagut, Enver Dayioglu
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