CEA術後脳神経麻痺合併の回避─自験連続216例の検討─

抄録

Cranial nerve palsy occurring after carotid endarterectomy (CEA) is the most common recognized complication, along with others such as stroke and myocardial infarction (MI). We examined the incidence and follow-up of cranial nerve palsy and other periprocedural major adverse events in 216 consecutive CEAs performed between January 2006 and December 2012. Six cranial nerve palsies (2 dysphonia, 1 dysphagia, 1 tongue hemiparesis, and 2 first bite syndromes) were identified in 4 patients (1.9%). All symptoms were transient and the patients recovered within 3 months. The incidence of perioperative stroke, death, and MI was 0%. Diffusion-weighted imaging performed on the day after surgery revealed an asymptomatic single spotty lesion in only 2 patients (0.9%). An optimal and meticulously conducted surgery based on a thorough knowledge of surgical anatomy could enable surgeons to avoid cranial nerve palsy and other major complications associated with CEA.