| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology, Wayne State University–Detroit Medical Center, MI.
Address correspondence and reprint requests to Dr. Seemant Chaturvedi, Department of Neurology, Wayne State University, 8C-UHC, 4201 St. Antoine, Detroit, MI 48201; e-mail: schaturv{at}med.wayne.edu
BACKGROUND: Previous studies have shown that neurologic complications following carotid endarterectomy (CE) are underestimated if patients are not examined by neurologists after surgery.
OBJECTIVE: To review the morbidity and mortality in a cohort of patients examined before and after CE in a neurology and stroke clinic.
METHODS: This was a prospective case series from an academic medical center; 44 patients were referred for CE during the period June 1995 to April 1999. Mean age was 64.3 years; 70.5% were referred for symptomatic stenosis and 29.5% were asymptomatic. Three neurosurgeons and two vascular surgeons operated on the patients.
RESULTS: The 30-day mortality rate was 4.5% and the 30-day stroke or death rate was 11.4%. One patient had a TIA due to thrombus formation at the operative site and a second patient had an asymptomatic intimal flap.
CONCLUSIONS: With prospective follow-up by neurologists, the CE complication rate in an academic medical center was significantly higher than the rates reported in controlled clinical trials. The generalizability of data from CE clinical trials is limited and local audits are necessary to better establish the risk/benefit ratio for individual hospitals and surgeons.
This article has been cited by other articles:
|
|
 |
|
  W. A. Gray, S. Chaturvedi, P. Verta, and on behalf of the Investigators and the Executive C Thirty-Day Outcomes for Carotid Artery Stenting in 6320 Patients From 2 Prospective, Multicenter, High-Surgical-Risk Registries Circ Cardiovasc Intervent, June 1, 2009; 2(3): 159 - 166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kastrup, T. Nagele, K. Groschel, F. Schmidt, E. Vogler, J. Schulz, and U. Ernemann Incidence of New Brain Lesions After Carotid Stenting With and Without Cerebral Protection Stroke, September 1, 2006; 37(9): 2312 - 2316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Renowden Interventional neuroradiology J. Neurol. Neurosurg. Psychiatry, September 1, 2005; 76(suppl_3): iii48 - iii63. [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Barr, J. J. Connors III, D. Sacks, J. C. Wojak, G. J. Becker, J. F. Cardella, B. Chopko, J. E. Dion, A. J. Fox, R. T. Higashida, et al. Quality Improvement Guidelines for the Performance of Cervical Carotid Angioplasty and Stent Placement: Developed by a Collaborative Panel of the American Society of Interventional and Therapeutic Neuroradiology, the American Society of Neuroradiology, and the Society of Interventional Radiology AJNR Am. J. Neuroradiol., November 1, 2003; 24(10): 2020 - 2034. [Full Text] [PDF]
|
|
|
|
|
|
R. Bond, K. Rerkasem, and P.M. Rothwell Systematic Review of the Risks of Carotid Endarterectomy in Relation to the Clinical Indication for and Timing of Surgery Stroke, September 1, 2003; 34(9): 2290 - 2301. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Liistro and C. Di Mario Carotid artery stenting Heart, August 1, 2003; 89(8): 944 - 948. [Full Text] [PDF]
|
|
|
|
|
|
A. Kastrup, K. Groschel, H. Krapf, B. R. Brehm, J. Dichgans, and J. B. Schulz Early Outcome of Carotid Angioplasty and Stenting With and Without Cerebral Protection Devices: A Systematic Review of the Literature Stroke, March 1, 2003; 34(3): 813 - 819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Barth and C. Bassetti Patient Selection for Carotid Endarterectomy: How Far Is Risk Modeling Applicable to the Individual? Stroke, February 1, 2003; 34(2): 524 - 527. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Chaturvedi and R. Fessler Angioplasty and stenting for stroke prevention: Good questions that need answers Neurology, September 10, 2002; 59(5): 664 - 668. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Kaufman, W.A.J. Hoefnagels, G. S. Roubin, G. New, and R. L. Sacco Extracranial Carotid Stenosis N. Engl. J. Med., May 16, 2002; 346(20): 1590 - 1591. [Full Text] [PDF]
|
|
|
|
|
|
W. A. Gray, H. J. White Jr, D. M. Barrett, G. Chandran, R. Turner, and M. Reisman Carotid Stenting and Endarterectomy: A Clinical and Cost Comparison of Revascularization Strategies Stroke, April 1, 2002; 33(4): 1063 - 1070. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Benade and C. P. Warlow Costs and Benefits of Carotid Endarterectomy and Associated Preoperative Arterial Imaging: A Systematic Review of Health Economic Literature Stroke, February 1, 2002; 33(2): 629 - 638. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. L. Hannan, A. J. Popp, P. Feustel, E. Halm, G. Bernardini, J. Waldman, D. Shah, and M. R. Chassin Association of Surgical Specialty and Processes of Care With Patient Outcomes for Carotid Endarterectomy Stroke, December 1, 2001; 32(12): 2890 - 2897. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. L. Bernardini, R. C. Darling III, D. M. Shah, R. Berguer, and H. J. M. Barnett Results of carotid endarterectomy with prospective neurologist follow-up Neurology, April 24, 2001; 56(8): 1119 - 1121. [Full Text] [PDF]
|
|
|
|
 |
|
 Carotid Endarterectomy: The Debate Continues Journal Watch Neurology, December 7, 2000; 2000(1207): 2 - 2. [Full Text]
|
|
|
|
|
|
H. J. M. Barnett and J. P. Broderick Carotid endarterectomy: Another wake-up call Neurology, September 26, 2000; 55(6): 746 - 747. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
