Ann Surg Treat Res.  2015 Nov;89(5):261-267. 10.4174/astr.2015.89.5.261.

Clinical outcomes of staged bilateral carotid endarterectomy for bilateral carotid artery stenosis

• Kim A
• Kwon TW
• Han Y
• Kwon SU
• Kwon H
• Noh M
• Cho YP

• KMID: 2095532
• DOI: http://doi.org/10.4174/astr.2015.89.5.261

Abstract

PURPOSE
This retrospective cohort study aimed to determine the clinical outcomes of staged bilateral carotid endarterectomy (CEA) for bilateral internal carotid artery (ICA) stenosis performed with a short interval between the primary and secondary CEA procedures.
METHODS
In our institution, 574 consecutive patients underwent CEA between September 2007 and August 2014. Bilateral significant ICA stenosis was identified in 43 patients (7.5%) who underwent staged bilateral CEA within 30 days or less. Patients with unilateral CEA and staged bilateral CEA were compared in terms of CEA outcomes. The primary endpoint was the composite of any stroke, myocardial infarction, or death during the periprocedural period or ipsilateral stroke within 3 years after the CEA.
RESULTS
Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up. The two groups did not differ in terms of estimated 3-year primary endpoint rates (2.8% vs. 4.7%, P = 0.456) or ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), or overall (P = 0.739) survival rates.
CONCLUSION
Patients with bilateral significant ICA stenosis can undergo staged bilateral CEA within 30 days or less with outcomes that compare favorably with those of patients undergoing unilateral CEA.

Keyword

Carotid stenosis; Treatment outcome; Carotid endarterectomy

MeSH Terms

Carotid Arteries*
Carotid Artery, Internal
Carotid Stenosis*
Cohort Studies
Constriction, Pathologic
Endarterectomy, Carotid*
Follow-Up Studies
Humans
Myocardial Infarction
Retrospective Studies
Stroke
Survival Rate
Treatment Outcome

Figure

• 

  Fig. 1 Flow chart of patient inclusion. ICA, internal carotid artery; CEA, carotid endarterectomy; CAS, carotid artery stenting.

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  Fig. 2 Ipsilateral stroke-free (A), any stroke-free (B), and overall survival rates (C) for patients who underwent unilateral carotid endarterectomy (CEA) and staged bilateral CEA.

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