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[Peroperative morbidity and mortality in thromboendarterectomy of the carotid bifurcation in patients with a previous stabilized stroke. Our results and review of the literature]

GIULINI, Stefano Maria;TIBERIO, Giorgio
1989-01-01
1989
Ateneo di appartenenza
LS7_7 Surgery
LS7_6 Gene therapy, stem cell therapy, regenerative medicine
ANNALI ITALIANI DI CHIRURGIA
2-s2.0-0024367145
Italiano
60
101
108
7
2683926
Carotid endarterectomy (CE), when performed in patients with previous stable stroke followed by complete or almost complete recovery, seems to be affected by a higher peroperative risk. From January 1982 to March 1988, we performed 230 CE in 207 patients, 188 (81.8\%, Group 1) in patients with TIA or an asymptomatic plaque and 42 (18.2\%, Group 2) in patients with previous strokes. The need for a temporary indwelling shunt has been evaluated with the measurement of carotid back pressure and, in the last 100 CEE, with the monitoring of somatosensory evoked responses (the shunt has however been used routinely anyway in the very first part of our experience). The incidence of carotid back-pressure values and of positive somatosensory evoked responses were similar in the two groups of C.E., even if the differences in the prealable evaluation were not statistically significant. The shunt has been nevertheless used more frequently in Group 2 (40.5 vs 28.2\%). Statistical analysis has been performed with the chi 2 method. The incidence of permanent and transient neurologic deficits and of the peroperative mortality due to neurological and non-neurological causes was, respectively, 0.5, 2.6, 1.6, 0\% (Group 1) and 2.4, 7.3, 2.4, 2.4\% (Group 2) (non-significant). If we exclude the first 50 operations (in which technical and/or anaesthesiological problems may have influenced the neurological outcome of the patients operated upon), the previous values become, respectively, 0,07*, 0,7, 0\% (Group 1) and 0, 5,5*, 0, 2,7\% (Group 2) (*p less than 0,01, the only significant difference).(ABSTRACT TRUNCATED AT 250 WORDS)
Carotid Artery Diseases; Endarterectomy; Humans; Intraoperative Complications; Ischemic Attack; Transient
6
info:eu-repo/semantics/article
262
M., Floriani; Giulini, Stefano Maria; M., Benvenuti; G., Pulcini; M., Giovanetti; Tiberio, Giorgio
1 Contributo su Rivista::1.1 Articolo in rivista
none
1.1 Articolo in rivista
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11379/30907
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