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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2005, Number 3

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Rev Mex Angiol 2005; 33 (3)

Carotic surgery: 1,200 cases in 12 years

Martínez LC, Sánchez MB, Barrera GG, Rosales JJM, Navarro CVH, Serrano GCA, Quezada LM, Arriola GHF, Bacelis ARA

Language: Spanish
References: 19
Page: 75-79
PDF size: 429.91 Kb.


ABSTRACT

Carotid endarterectomy represents an important resource to prevent incapacity and death by cerebral vascular events in risk population.
Objective: The experience found in 1,200 cases of carotid surgery is exposed, describing the symptoms and image studies findings, as well as resulting morbidity from the surgery.
Methods: Retrospectively we describe the experience of the cases of carotid surgery made in the Angiology and Vascular Surgery Service of the Specialties’ Hospital of the National Medical Center Century XXI, of the IMSS from July 1993 to July 2004 finding 1,200 surgeries. Female patients were 60% and the other 40%, masculine; the symptoms found: transient ischemic attack in 55%, amaurosis fugax in 15%, cerebral infarct 15%, reversible ischemic neurologic deficit (RIND) 12% and non symptomatic in 3%.
Results: The postoperating cerebral infarction appeared only in 2%, the nervous injuries took place in 5%. Of the 540 transient ischemic attack patients who presented/displayed attack, 487 related remission of the symptoms referred previous to the surgery. In 324 patients with previous cerebral infarct or with RIND, 18 continued with the same manifestations subsequent to the surgical event.
Conclusions: The experience presented in the carotid surgery showed acceptable morbidity and in accordance with the respective literature. The medical community in general must take preventive measures in patients with risk factors, thus to foresee the incapacity and death that significantly affect the population.


REFERENCES

  1. NASCET. Clinical alert: benefit of carotid endarterectomy for patients with high-grade stenosis of the internal carotid artery. National Institute of Neurological Disorders and Stroke, Stroke and Trauma Division. North American Symptomatic Carotid Endarterectomy Trial (NASCET) investigators. Stroke 1991; 22: 816-7.

  2. Easton JD, Sherman DG. Stroke and mortality rate in carotid endarterectomy: 228 consecutive operations. Stroke 1977; 8: 565-8.

  3. Shaw DA, Venables GS, Cartlidge NE, Bates D, Dickinson PH. Carotid endarterectomy in patients with transient cerebral ischaemia. J Neurol Sci 1984; 64: 45-53.

  4. Fisher ES, Malenka DJ, Solomon NA, Bubolz TA, Whaley FS, Wennberg JE. Risk of carotid endarterectomy in the elderly. Am J Public Health 1989; 79: 1617-20.

  5. Estes JM, Guadagnoli E, Wolf R, Logerfo FW, Whittemore AD. The impact of cardiac comorbidity after carotid endarterectomy. J Vasc Surg 1998; 28: 577-84.

  6. Perler BA, Dardik A, Burleyson GP, Gordon TA, Williams GM. Influence of age and hospital volume on the results of carotid endarterectomy: a state-wide analysis of 9,918 cases. J Vasc Surg 1998; 27: 25-31.

  7. O’Hara PJ, Hertzer NR, Mascha EJ, Beven EG, Krajewski LP, Sullivan TM. Carotid endarterectomy in octogenarians: early results and late outcome. J Vasc Surg 1998; 27: 860-9.

  8. Haynes RB, Wilczynski N, McKibbon KA, Walker CJ, Sinclair JC. Developing optimal search strategies for detecting clinically sound studies in Medline. J Am Med Inform Assoc 1994; 1: 447-58.

  9. North American Symptomatic Carotid Endarterectomy Trial collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 1991; 325: 445-53.

  10. European Carotid Surgery Trialists’ collaborative Group. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. Lancet 1991; 337: 1235-43.

  11. European Carotid Surgery Trialists’ Collaborative Group. Randomized trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial. Lancet 1998; 1379-87.

  12. Eliasziw M, Smith RF, Singh N, Holdsworth DW, Fox AJ, Barnett HJ. Further comments on the measurement of carotid stenosis from angiograms. North American Symptomatic Carotid Endarterectomy Trial (NASCET) group. Stroke 1994; 25: 2445-9.

  13. Rothwell PM, Gibson RJ, Slattery J, Sellar RJ, Warlow CP. Equivalence of measurements of carotid stenosis. A comparison of three methods on 1,001 angiograms. European Carotid Surgery Trialists’ collaborative group. Stroke 1994; 25: 2435-9.

  14. Cochrane Collaboration Handbook 3.0.2 [updated September 1997]. In: The Cochrane library [database on disk and CD-ROM]. The Cochrane Collaboration. Mulrow, CD, Oxman, AD. Issue 3. 1998. Oxford, Update Software.

  15. Barnett HJ. North American Symptomatic Carotid Endarterectomy Trial. Methods, patient characteristics, and progress. Stroke 1991; 22: 711-20.

  16. Barnett HJ. Status report on the North American Symptomatic Carotid Surgery Trial. J Mal Vasc 1993; 18: 202-8.

  17. Barnett HJ. Symptomatic carotid endarterectomy trials. Stroke 1990; 21: III-2-5

  18. Sprouse IILR. MD, Patrick P. MD, Bosiers M. MD, The capture of visible debris by distal cerebral protection filters during carotid artery stenting: Is it predictable?, Journal of Vascular Surgery, 2005; 6: 40-8.

  19. Eliasziw M, Streifler JY, Fox AJ, Hachinski VC, Ferguson GG, Barnett HJ. Significance of plaque ulceration in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial. Stroke 1994; 25: 304-8.




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