抄録
We evaluated long-term outcomes in patients treated with carotid endarterectomy (CEA). Postoperative intima-media thickness (IMT) and peak systolic velocity (PSV) were measured using duplex ultrasonography in 38 patients. In addition, the long-term survival of the patients after CEA was assessed. The mean follow-up period was 60 months. The IMT was increased in 15 patients, and changing patterns were categorized into the three following groups: gradual increase, transient peak, and plateau. Postoperative uncontrolled diabetes mellitus (defined as HbA1c level of >7.0) was the only predictor of increased IMT of ≥2 mm. Restenosis (defined as >50% stenosis or >150 cm/s of PSV) or occlusion of the internal carotid artery occurred in 2 patients (5%). In the present case with restenosis, spontaneous restoration was observed after hospitalization without smoking habit for 6 months. Other diseases that required treatment were found in 18 patients (47%) despite routine preoperative systemic examination such as blood examination and chest X-ray photography, and evaluation of current ischemic coronary disease. Of the 18 patients, 6 had cancer and 7 had cardiovascular events. One patient died because of pancreatic cancer, and another patient with acute subdural hematoma had a decrease in modified Rankin scale score. These results indicate that careful postoperative follow-up of IMT and systemic surveillance may play a key role to achieve favorable long-term out-come after CEA.
