Evaluation of carotid endarterectomy for patients with asymptomatic carotid stenosis

Abstract

We evaluated carotid endarterectomy (CEA) for use in patients with asymoptomatic carotid stenosis (As-CS). Among 287 cases of CEA, 90 were performed for As-CS. We divided the 90 patients concerned into three groups : Group A, CEA performed for As-CS after CEA for symptomatic carotid stenosis : Group B, CEAs performed for bilateral As-CS; and Group C, CEA performed for single As-CS. Coronary angiography was carried out in 39 of these patiets, and coronary stenosis was evaluated by Gensini's scoring systom (GS). The overall mortality and morbidy was 3.1%, with the values for Groups A, B and C being 5.9%, 8.3% and 1.5%, respectively. Twenty-one of the above 39 patients showed values of more than 6 for GS, and 10 patients among them underwent coronary artery reconstruction before or after CEA. Eighty-two patients (91.1%) were discharged without neurological deficis. Among 80 patients who could be followed up for a long period (mean, 68.2 months) 15 patients died. Six of them died of cardiovascular disease. In conclusion it can be said that although the overall results of CEA for As-CS were generally good, care most be taken in cases of bibateral CEA (Groups A and B). Since coronary lesions tend to be associated with As-CS, it is important to check and treat such lesions in order to reduce the mortality and morbidity of CEA.