Abstract
We performed 79 carotid endarterectomies in 72 patients in the last 7 years. This report describes surgical results, complications and follow-up in those endarterectomies. We used internal shunts under barbiturate brain protection in all cases. The mean time for shunt insertion and removal is 3 minutes and 4.5 minutes, respectively. We used surgical microscope and removed plaques as a whole block. The surgical mortality was 2.8% (2 cases) and major morbidity was 2.8% (2 cases). The cause of operative death in two cases was rupture of the suture, which resulted in blood loss and subsequent fatal infarction. One case of major infarction was caused by temporary occlusion of the carotid artery. The bilateral vertebral arteries of this case were occluded, and collaterals were from the carotid artery through the stenotic part. The other case of major infarction was caused by inappropriate collection of the intimal flap and inappropriate usage of the large-sized internal shunt. The follow-up disclosed only one case of infarction occurred in the surgical side, because the patient failed to take anti-platelet drugs. Two cases developed symptomatic restenosis of the endarterectomy site because of myointimal hyperplasia. Complication of endarterectomy can be avoided by careful intra- and postoperative care.
