COMPARISON OF RESULTS OF BILATERAL AND UNILATERAL CAROTID ENDARTERECTOMY 5 YEARS AFTER SURGERY

  • 1 January 1982
    • journal article
    • research article
    • Vol. 91  (3) , 258-262
Abstract
Consecutive patients who successfully underwent carotid endarterectomy (CE) between 1970-1975 were followed during a 5-yr period (mean follow-up 4.3 yr). The patients were divided into 3 groups. Group I comprised 146 patients who had unilateral CE with a patent, nonstenotic contralateral carotid artery. Group II included 45 patients who underwent unilateral CE but whose contralateral internal carotid artery was totally occluded. Group III consisted of 86 patients who underwent bilateral CE. There was no significant difference between the groups with respect to age, sex, neurologic status or associated diseases, and all were maintained on antiplatelet medications after surgery. During the follow-up period a total of 22 of the 277 patients had a new hemispheric stroke; 4 others became comatose and died, presumably of stroke. Among the group I patients, 17 had new strokes, only 6 of which involved the hemisphere ipsilateral to the CE. Five late strokes occurred in group II, 1 ipsilateral to the CE. Four patients in group III had new strokes. The cumulative stroke rates at 5 yr by the life-table method were 17.6% for group I, 16.4% for group II and 5.6% for group III. The difference between groups I and III was significant (P < 0.05). Patients undergoing unilateral CE should have close postoperative monitoring of the contralateral vessel.

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