Carotid endarterectomy without preoperative angiography

  • Elias Bastounis
  • Chr. Maltezos
  • P. Balas
Conference paper


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.


Carotid Endarterectomy Carotid Bifurcation Carotid Artery Disease Duplex Scanning Carotid Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Blackshear WM, Connar RG (1982) Carotid endarterectomy without arteriography. J Cardiovasc Surg 23: 477–482Google Scholar
  2. 2.
    Balas P, Bastounis E, Pangratis N, Xeromeritis N, Masouridou E (1994) Carotid endarterectomy without cerebral arteriography. Intern Angiol 13: 18Google Scholar
  3. 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
  4. 4.
    Crew J R, Dean M, Johnson JM et al. (1984) Carotid surgery without angiography. Am J Surg 148: 217–220PubMedCrossRefGoogle Scholar
  5. 5.
    Dowson DL, Zierler RE, Kohler TR (1991) Role of arteriography in the preoperative evaluation of carotid artery disease. Am J Surg 161: 619–624CrossRefGoogle Scholar
  6. 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
  7. 7.
    Giender JW, Lampavello PJ, Rites TS et al. (1989) Is duplex scanning sufficient evaluation before carotid endarterectomy? J Vase Surg 9: 193–201CrossRefGoogle Scholar
  8. 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
  9. 9.
    Hankey GJ, Warlow CP, Sellar RJ (1990) Cerebral angiographie risk in mild cerebrovascular disease. Stroke 21: 209–222PubMedCrossRefGoogle Scholar
  10. 10.
    Hill JC, Carbonneau K, Baliga PK et al. (1990) Safe extracranial vascular evaluation and surgery without preoperative arteriography. Ann Vasc Surg 4: 34–37PubMedCrossRefGoogle Scholar
  11. 11.
    Leahy AL, McCollum PT, Feeley MC (1988) Duplex ultrasonography and selection of patients for carotid endarterectomy: Plaque morphology or luminal narrowing? J Vasc Surg 8: 558–562PubMedGoogle Scholar
  12. 12.
    Martin JD, Valentine RJ, Myers SI et al. (1991) Is routine CT scanning necessary in the preoperative evaluation of patients undergoing carotid endarterectomy? J Vasc Surg 14: 267–270PubMedCrossRefGoogle Scholar
  13. 13.
    Moore WS, Ziomek S, Quinones-Baldrich WJ et al. (1988) Can clinical evaluation and noninvasive testing substitute for arteriography in the evaluation of carotid artery disease? Ann Surg 208: 91–94PubMedCrossRefGoogle Scholar
  14. 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
  15. 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. 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. 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

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • Elias Bastounis
    • 2
    • 1
  • Chr. Maltezos
    • 1
  • P. Balas
    • 1
  1. 1.First Surgical DepartmentUniversity of AthensGreece
  2. 2.“Laiko” General HospitalAthensGreece

Personalised recommendations