Postoperative Stroke and Late Neurologic Complications After Carotid Endarterectomy

摘要: • From 1969 through 1973, 335 consecutive patients (mean age, 60 years) underwent 390 carotid endarterectomies using hypercarbic general anesthesia and no shunting. Early neurologic complications were most common among with previous symptoms those subtotal stenosis or occlusion of the contralateral internal artery. The introduction routine shunting without hypercarbia during a subsequent series 626 procedures from 1974 1978 has been associated significantly fewer operative strokes in comparable groups patients. Complete follow-up information mean interval 8.6 years is available for 95% 325 survivors. Late completed have occurred 17% but involved cerebral hemisphere on side endarterectomy only 7%. Of 93 survivors who had artery, 45 as an elective procedure 48 did not. late stroke rates these two 4% 16%, respectively, although differences not attain statistical significance. Forty-nine (78%) 63 following unilateral endarterectomy. (Arch Surg1981;116:1561-1568)