Carotid Endarterectomy with Contralateral Carotid Artery Occlusion: is this a Higher Risk Subgroup?

Abstract

the presence of contralateral carotid occlusion caused an increased use of shunt, but not in early complications rates.

Carotid endarterectomy in female patients

“…21,22 However, in our study, females with contralateral occlusion were found to have higher perioperative stroke rates than both females without contralateral occlusion and males with contralateral occlusion, even if the number of females with contralateral occlusion and the number of events in this subgroup is quite small, limiting the statistical significance of this finding. It is difficult to explain why in our series contralateral carotid occlusion could have such a significant impact in women; possibly, a diminished collateral blood flow capacity in smaller vessels, such as in females with contralateral occlusion, may in some way increase the risk of neurological events both in the perioperative period and during follow-up.…”

Early and long-term results of carotid endarterectomy in diabetic patients

“…Anatomical factors such as contralateral occlusion also did not increase the risk of perioperative complications in diabetics, confirming previous data from our group. 18 We did not find any difference in terms of cumulative 30-day stroke and death rate between symptomatic and asymptomatic diabetic patients, and this was also true when a separate analysis for 30-day death and stroke rates was performed. Of interest is the observation that, when comparing 30-day stroke and death rate in asymptomatic diabetic and nondiabetic patients, the corresponding values were 2.1% and 0.7%, confirming that diabetes plays an important role in increasing perioperative risk of CEA also in asymptomatics, who are usually considered at lower surgical risk, as suggested by the results in the entire study group and in group 2.…”

Análise crítica das indicações e resultados do tratamento cirúrgico da doença carotídea

“…4 However, recent studies have demonstrated good outcomes of CEA in patients with CLO, with mortality and neurological complications close to 5% (Table 2). [40][41][42][43][44][45][46][47][48][49] By analyzing NASCET data, it is possible to observe some causes that might have been important for the poor outcomes in this group of patients. The sample of patients with CLO was small (n = 21) and the neurological events occurred in the immediate postoperative period.…”