Carotid endarterectomy without preoperative angiography
Three-hundred-and-twenty-eight endarterectomies of the carotid artery in 328 patients were carried out from January 1, 1987 to December 1994 in the 1st Surgical Dept, University of Athens Medical School. There were 243 males (82.93%) and 50 (17.07%) females. The mean age of the above patients was 67.5 years. One-hundred-and-forty-four endarterectomies were done without preoperative angiography; instead ultrasonography using Duplex or Triplex scanning was used, while in the remaining 184 endarterectomies an angiographic investigation of the carotids was performed. This study was undertaken to compare the postoperative results, the mortality and morbidity in the first 30 days postoperatively as well as their postoperative complications, which showed that the difference between the two groups was not statistically significant. The surgical findings as regards the stenosis rate and texture of the atheromatic plaque together with the corresponding preoperative data are also compared.
The results compiled up to the present date show that the ultrasonographic control of the carotids can establish exactly the indications for endarterectomy of the carotid artery and, many times, the angiographie study is not necessary for the assessment of the occlusive changes of the carotid bifurcations.
KeywordsCarotid Endarterectomy Carotid Bifurcation Carotid Artery Disease Duplex Scanning Carotid Surgery
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- 1.Blackshear WM, Connar RG (1982) Carotid endarterectomy without arteriography. J Cardiovasc Surg 23: 477–482Google Scholar
- 2.Balas P, Bastounis E, Pangratis N, Xeromeritis N, Masouridou E (1994) Carotid endarterectomy without cerebral arteriography. Intern Angiol 13: 18Google Scholar
- 3.Balas P (1992) Are the ultrasonic imaging technics (duplex or triplex) alone sufficient for decision-making in carotid endarterectomy? Pros and Cons Intern Angiology 2: 91–93Google Scholar
- 6.Flanigan DP, Schuter JJ, Vogel M et al. (1985) The role of carotid duplex scanning in surgical decision making. J Vasc Surg 215–225Google Scholar
- 8.Gerther JP, Cambia RP, Kistler JP et al. (1990) Carotid surgery without arteriography: Non-invasive selection of patients. Ann Vase Surg 4: 2. 53–256Google Scholar
- 14.Wagner WH, Treiman RL, Cossman DV et al. (1990) The diminishing role of diagnostic arteriography in carotid artery disease: Duplex scanning as definite preoperative study. 15th Annual Meeting of the Peripheral Vascular Surgery Society, June 2, L. Angeles-CalifGoogle Scholar
- 1.5.Pedrini L, Paragona O, Disano E et al. (1991) Morbidity and mortality following carotid surgery. J Cardiovasc Surg 32: 720–725Google Scholar
- 16.Ricotta JJ, Holen J, Schenk E et al. (1984) Is routine angiography necessary prior to carotid endarterectomy? J Vase Surg 1: 96–102Google Scholar
- 17.Goodson SF, Flanigan DP, Bishara RA, Schuler JF, Kikta MS, Mayer JP (1987) Can carotid duplex scanning supplant arteriography in patients with focal carotid territory symptoms? J Vase Surgery 5: 551–55Google Scholar