1994 Volume 22 Issue 1 Pages 9-14
In this report, we reviewed surgical results, complications and late prognosis of 73 carotid endarterectomies on 63 patients with cervical carotid artery stenosis in the last 6 years. We performed microsurgical endartrectomy with internal shunts and electrophysiological monitoring, such as EEG and somatosensory evoked potentials. Perioperative complications were found in 7 patients (9.6%), cerebral infarction in 4 patients, transient hypoglossal nerve palsy in one, acute hepatitis in one, and pneumonia in one. In 2 patients, thromboembolism, caused by a transient obstruction of internal shunts, resulted in major neurological deterioration. On the other hand, hemodynamic ischemia caused no or minor neurological deterioration in 2 patients who had severe stenosis of the carotid artery and reduced perfusion reserve. In follow-up periods (mean 24.5 months), 4 patients (5.5%) have developed cerebral infarction, ipsilateral carotid artery territory in three (4.1%) and vertebrobasilar artery territory in one. Another patient died of myocardial infarction. We mainly discussed how to avoid perioperative complications, especially cerebral infarction, in this report.
