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J.Jpn. Surg. Soc.. 89(3): 431-436, 1988


Original article

CAROTID ENDARTERECTIOMIES FOR CEREBRAL ISCHEMIA: A FOLLOW UP STUDY OF SURGICAL RESULTS AND LATE NEUROLOGIC COMPLICATIONS

*) The First Department of Surgery, Nagoya University School of Medicine, Nagoya, Japan
**) Department of Surgery, Aichi Prefectural Owari Hospital, Ichinomiya, Japan

Tsunehisa Sakurai*), Ikuo Yamada*), Teruo Ikezawa*), Shigehiko Shionoya*), Yukifumi Nakata**)

Twenty five carotid endarterectomies were performed in 24 patients with cerebral ischemia due to atherosclerosis. Four of these patients were asymptomatic, 7 suffered from hemispheric TIA (hemispheric attack group), 7 suffered from nonhemispheric TIA (nonhemispheric attack group) and other 6 had previous completed stroke (completed stroke group). The average length of follow-up study was two and half years with a range of 2 months to 6 years. Completed strokes occurred in 1 patient following the operation and in 3 patients during the follow-up period (16.7%). Two patients were reoperated upon because of recurrent carotid stenosis (8.3%). Four patients continued to have neurologic symptoms postoperatively. Ultimately 10 of 24 patients had some neurologic complications even following carotid endarterectomies (41.7%). The first postoperative year was the worst period because almost all late neurologic complications occurred in that time. Kaplan-Meier's analysis demonstrated a relatively favorable result in the hemispheric attack group among these 3 groups. The completed stroke group was followed by that and the nonhemispheric attack group was proved to be the worst, although there was no statistical significance.


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