抄録
Surgical indication for carotid stenotic lesions is a matter discussed for a long time but has not settled completely. Carotid stenotic lesions in Japan have been reported less frequently than in Caucasion countries and our previous studies indicate that the degree of the pathologies and a natural history of the disease are more benign. In addition, many patients (68%of total, studied) with carotid occlusive lesions either unilaterally or bilaterally had ipsilateral or bilateral intracranial arterial occlusive diseases. Accordingly, the surgical indications in Japan should include these characteristics of the disease and provide multiple situations since presence of the intra- and extracranial lesions creats multiple combinations. The authors have utilized a surgical indication for the past 4 years and performed 31 carotid endarterectomies according to the indication. The indication consists of 31 items to be checked as in a checklist.
Operative results were presented in three different periods according to the surgical indications utilized, and the results were compared with others. The result obtained from the period of present indication demonstrated an improvement in the rate (0%) of surgical failure (a rate of recurrence of preoperative neurological symptoms) but not in the mortality (3.2%). A brief discussion was made with regard to this.
