Prevalence and Clinical Consequences of Carotid Artery Residual Defects Following Endarterectomy: A Prospective CT Angiography Evaluation Study

Kolk, Anja G. van der; Borst, G.J. de; Jongen, Lisa M.; Hartog, A.G. den; Moll, Frans L.; Mali, W.P.Th.M.; Hendrikse, J.

doi:10.1016/j.jvs.2011.06.008

Cited by 2 publications

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“…Although the carotid irregularities are common after carotid surgery, they rarely cause re-stenosis (7). ese irregularities are intimal aps, intimal steps and dissecting lesions (8). Previous reports using ultrasound showed that in patients with surgery for symptomatic high grade stenosis asymptomatic dissecting lesions of carotid arteries are 5% (6).…”

Section: Discussionmentioning

confidence: 99%

Dissecting lesions of common carotid artery after carotid surgery: a case report

Budinčević¹,

Ivkošić²,

Vidjak³

et al. 2022

Rad Hrvatske akademije znanosti i umjetnosti

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is case report represents rare complication of carotid surgery, iatrogenic dissection of the common carotid artery and its successful endovascular treatment. We herein report a case of 55 year-old female patient in whom carotid surgery was performed due to constant tinnitus caused by kinking of right internal carotid artery. On day 7 th carotid control ultrasound was performed, according to hospital's protocol. e carotid ultrasound showed dissecting lesion of right common carotid artery in a length of three centimeters that was con rmed with computed tomography angiography of neck vessels, and dual antithrombotic therapy was initiated. One month later percutaneous angioplasty was performed with stent implantation.

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Section: Discussionmentioning

confidence: 99%

Dissecting lesions of common carotid artery after carotid surgery: a case report

Budinčević¹,

Ivkošić²,

Vidjak³

et al. 2022

Rad Hrvatske akademije znanosti i umjetnosti

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“…20 Published results of CTA after CEA have only reported findings several days 13 to months 20 after CEA. We focused on early CTA (< 24 hours), since rapid (typically 64-detector) CT-based acquisition of parenchymal and vascular neuroimaging is now routinely part of acute stroke protocols at many institutions, 22 and has been advocated for workup of perioperative stroke after CEA.…”

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confidence: 99%

64-detector CT angiography within 24 hours after carotid endarterectomy and correlation with postoperative stroke

Gallati¹,

Jain²,

Damania³

et al. 2015

JNS

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W hile carotid endarterectomy (CEA) is a wellestablished treatment for patients with carotid stenosis, 2,11,21 it is associated with a small but not insignificant rate (3.9%-6.5%) of perioperative stroke/transient ischemic attack (TIA). 9,16 This can necessitate urgent postoperative neuroimaging of the brain and supplying vasculature. Imaging findings associated with ischemic/hemorrhagic stroke 3,5,18,26 and hyperperfusion syndrome 12 after CEA are well reported, as are arterial changes (days to weeks) 8,19 and restenosis (months to years) 6,7,10,17 after CEA. However, there are few studies examining the carotid artery within the early 24-hour period following CEA (during which more than 75% of perioperative strokes occur), 9 and, to our knowledge, all have relied upon duplex ultrasound. obJect Carotid endarterectomy (CEA) carries a small but not insignificant risk of stroke/transient ischemic attack (TIA), most frequently observed within 24 hours of surgery, which can lead to the need for urgent vascular imaging in the immediate postoperative period. However, distinguishing expected versus pathological postoperative changes may not be straightforward on imaging studies of the carotid artery early after CEA. The authors aimed to describe routine versus pathological anatomical findings on CTA performed within 24 hours of CEA, and to evaluate associations between these CTA findings and postoperative stroke/TIA. methods The authors reviewed 113 consecutive adult patients who underwent postoperative CTA within 24 hours of CEA at a single academic institution. Presence and location of arterial "flaps," luminal "step-off," intraluminal thrombus and hematoma were documented from postoperative CTA scans. Medical records were reviewed to determine the incidence of new postoperative neurological findings. results Postoperative CTA findings included common carotid artery (CCA) step-off (63.7%), one or more intraarterial flaps (27.4%), hematoma at the surgical site (15.9%), and new intraluminal thrombus (7.1%). Flaps were seen in the external carotid artery (ECA), internal carotid artery (ICA), and CCA in 18.6%, 9.7%, and 6.2% of patients, respectively. New postoperative neurological findings were present in 7.1% of patients undergoing CTA. Flaps (especially ICA/CCA) and/ or intraluminal thrombi were more frequently seen in patients undergoing CTA for new postoperative stroke/TIA (85.7%) versus patients undergoing CTA for routine postoperative imaging (14.3%, p = 0.002). coNclusioNs CTA within 24 hours of CEA demonstrates characteristic anatomical findings. CCA step-offs and ECA flaps are relatively common and clinically insignificant, whereas ICA/CCA flaps and thrombi are less frequently seen and are associated with postoperative stroke/TIA.

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Prevalence and Clinical Consequences of Carotid Artery Residual Defects Following Endarterectomy: A Prospective CT Angiography Evaluation Study

Cited by 2 publications

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Dissecting lesions of common carotid artery after carotid surgery: a case report

Dissecting lesions of common carotid artery after carotid surgery: a case report

64-detector CT angiography within 24 hours after carotid endarterectomy and correlation with postoperative stroke

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