This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Logason, K. Articles by Ljungman, C. Search for Related Content PubMed PubMed Citation Articles by Logason, K. Articles by Ljungman, C. Social Bookmarking                         What's this?

Carotid Artery Endarterectomy Solely Based on Duplex Scan Findings

Department of Surgery, University Hospital, Uppsala, 751 85, Sweden

Sadettin Karacagil, MD, PhD

Department of Surgery, University Hospital, Uppsala, Sweden

Hans-Göran Hårdemark, MD, PhD

Department of Neurology, University Hospital, Uppsala, Sweden

Annika Boström, MD

Anders Hellberg, MD, PhD

Christer Ljungman, MD, PhD

Department of Surgery, University Hospital, Uppsala, Sweden

The purpose of this study was to review experience with carotid artery surgery based on findings obtained solely from duplex scanning with special regard to unexpected findings during surgery and the early outcome. From January 1993 through December 1999, 271 consecutive patients underwent 287 carotid endarterectomies (CEAs), 229 (80%) of which were performed solely based on duplex scan findings. During the study period 5,932 carotid artery duplex scans were performed in 4,466 patients. Of 589 patients with internal carotid artery (ICA) stenosis? 70%, 246 underwent CEA compared to 25 of 156 with 50-69% ICA stenosis. The indications for CEA were transient ischemic attack (TIA) in 88 (30.7%), amaurosis fugax in 60 (20.9%), previous stroke in 91 (31.7%) and asymptomatic disease in 48 (16.7%) cases.

There were no statistically significant differences between the groups operated on with and without preoperative angiography with respect to the indications for surgery, associated risk factors, or the degree of stenosis on the contralateral side. In patients undergoing surgery without angiography, there were no unexpected findings that influenced the performance of surgery, in all except 1. There were no significant differences in perioperative morbidity and mortality in patients undergoing surgery with and without conventional angiography. The combined mortality and major stroke rates were 3.4% and 2.2%, respectively.

It is concluded that CEA can safely be performed without preoperative angiography in cases with conclusive duplex scan findings.

Vascular and Endovascular Surgery, Vol. 36, No. 1, 9-15 (2002)
DOI: 10.1177/153857440203600103


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. Crane and N. Cheshire Recent developments in vascular surgery BMJ, October 18, 2003; 327(7420): 911 - 915. [Full Text] [PDF]