The Risk of Surgical Therapy to Patients with Unilateral Stenosis and Contralateral Occlusion of the Carotid Artery

Summary

A total of 384 supra-aortic branches were operated in 318 patients. Forty-four operations were carried out on 35 patients with unilateral stenosis and contralateral occlusion of the internal carotid artery (aci). Eighteen patients were classified in stage IV. The symptomatology was largely determined by the occluded side (27 patients). In 23 cases only the stenosis was operated, in 3 cases only the occlusion. Both sides were operated in 9 cases. The rate of mortality within the first 30 days was 11.4 % (cerebral death: 2 patients, non-cerebral death: 2 patients). The rate of mortality within a time span of up to 10 years was 20 % (7 patients).

Early results showed that the condition of one patient in stage III and 4 patients in stage IV had improved. Two patients deteriorated clinically, while the other 28 patients remained unchanged, although with some improvement in respect to stage II. Long-term results showed that only one patient of the surviving 24 patients had worsened clinically (2 years postoperatively), and 5 patients showed no improvement An improvement in neurological condition was observed in 18 patients.

This retrospective study shows that although a higher risk is involved in surgical therapy of carotid stenosis and occlusion than of carotid stenosis alone, it definitely provides better results than do all forms of conservative therapy. The revascularization of non-chronic occlusion thus can be successful.

Key-Words:

Carotid Surgery Risk - Carotid-Stenosis-Occlusion-Type