Abstract
I have performed consecutive 220 operations of carotid endarterectomy (CEA) with a fixed team for these 20 years, and reviewed surgical outcome and long term follow-up results.
We have routinely used a shunt system and intraoperative monitoring under general anesthesia. The patients were followed up for 6.5 years on average, and activity of daily life (ADL) was evaluated. Four patients (2.0%) showed neurological deficits after operation, however, all were seen in the initial period of more than 10 years ago. Mortality was 0%. This data is superior to the results of NASCET and ACAS.
One hundred and sixty patients were followed up for more than 1 year. Four patients had re-stenosis of the operated internal carotid artery, and 2 of them underwent CEA again, while asymptomatic period. Four patients had ischemic attack in the operated side but with intracranial lesions. Aggravation of ADL was recognized in 28 patients without carotid lesions. There were 19 deaths, 10 of which were caused by cancers. Twenty seven patients had ischemic heart diseases, and 6 of them died. CEA is effective for prevention of cerebral infarction, when practiced surgeons perform with a shunt system and intraoperative monitoring. However, general examination and treatment with cardiologists are necessary to detect ischemic heart diseases.
