J.Jpn. Surg. Soc.. 80(12): 1607-1611, 1979

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Report on the annual meeting

SURGICAL TREATMENT OF CAROTID OCCLUSIVE LESIONS (COLs)

Clinicopathological aspects of carotid occlusive lesions (COL) and results of surgical treatment for the COL were presented. The case material included both Japanese and American patients. In clinical symptoms of Japanese patients, incidence of amaurosis fugax was low while speech disturbance was more frequently found than in American patients. Pathological study of Japanese COLs with light and electron microscope revealed less severity in atherosclerotic changes and indicated that a hemodynamic mechanism is more likely as the cause of cerebral ischemia especially in a steep type of the COL. In the light of these findings and differences, the author have proposed and utilized a method of treatment for Japanese COLs, which consists of new diagnostic criteria for the COL, multi-itemized surgical indications and microsurgical techniques. The results of the method were satisfactory in reducing the rate of recurrence of cerebral ischemia in a follow-up period. However, patients who belonged to the Ab-1 group (or hemiparesis with various arterial pathology) had higher mortality and morbility. The author concluded that the operative result will be improved when the surgical indication for the Ab-1 is reevaluated by comparing the natural history of the group to that of normal population.

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