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Neurologic complications following carotid artery surgery: pathophysiology and predictive factors

Authors :
François Ondondong
Roland Sambuc
Alain Branchereau
Jack Bordeaux
Source :
Annals of Vascular Surgery. 1:79-85
Publication Year :
1986
Publisher :
Elsevier BV, 1986.

Abstract

This study analyzes the results of 457 carotid artery operations done in 416 patients by the same surgeon during a five-year period. A total of 27 central neurologic complications were observed, 14 were transient and 13 were permanent neurologic deficits, nine of which resulted in death. The causes of these accidents were: embolism (12), intolerance to clamping (7), carotid thrombosis (3), and reperfusion injury (2). In three cases no cause could be found. Preoperative predictive factors for these complications were analyzed statistically by multivariate analysis techniques. A high-risk group was identified, characterized by diffuse atherosclerotic disease and by the presence of a previous neurologic deficit. The prevention of neurologic complications in carotid surgery goes far beyond the controversy of whether or not a temporary inlying shunt should be used. In our opinion indications for shunting are limited. Neurologic complications can be prevented by maintaining awareness of certain temporary contraindications in patients with permanent neurologic deficits and by exacting operative techniques.

Details

ISSN :
08905096
Volume :
1
Database :
OpenAIRE
Journal :
Annals of Vascular Surgery
Accession number :
edsair.doi.dedup.....22bd98d1428110001d462b828e60a8c5
Full Text :
https://doi.org/10.1016/s0890-5096(06)60707-3