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Titolo:
THE CAUSE OF PERIOPERATIVE STROKE AFTER CAROTID ENDARTERECTOMY
Autore:
RILES TS; IMPARATO AM; JACOBOWITZ GR; LAMPARELLO PJ; GIANGOLA G; ADELMAN MA; LANDIS R;
Indirizzi:
NYU,MED CTR,DEPT SURG,DIV PERIPHERAL VASC SURG,530 1ST AVE,SUITE 6F NEW YORK NY 10016
Titolo Testata:
Journal of vascular surgery
fascicolo: 2, volume: 19, anno: 1994,
pagine: 206 - 216
SICI:
0741-5214(1994)19:2<206:TCOPSA>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUROLOGIC COMPLICATIONS; ARTERY OCCLUSION; STENOSIS; SURGERY; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
32
Recensione:
Indirizzi per estratti:
Citazione:
T.S. Riles et al., "THE CAUSE OF PERIOPERATIVE STROKE AFTER CAROTID ENDARTERECTOMY", Journal of vascular surgery, 19(2), 1994, pp. 206-216

Abstract

Purpose: The purpose of this study was to examine the cause of perioperative stroke after carotid endarterectomy. Methods: The records of 2365 patients undergoing 3062 carotid endarterectomies from 1965 through 1991 were reviewed. Sixty-six (2.2%) operations were associated witha perioperative stroke. The mechanism of stroke was determined in 63 of 66 cases. Patient risk factors and surgeon-dependent factors were analyzed. Results: More than 20 different mechanisms of perioperative stroke were identified, but most could be grouped into broad categoriesof ischemia during carotid artery clamping (n = 10), postoperative thrombosis and embolism (n = 25), intracerebral hemorrhage (n = 12), strokes from other mechanisms associated with the surgery (n = 8), and stroke unrelated to the reconstructed artery (n = 8). Dividing the operative experience approximately into thirds, during the years 1965 to 1979, 1980 to 1985, and 1986 to 1991 the perioperative stroke rates were2.7%, 2.2%, and 1.5%, respectively. This, in part, is associated witha better selection of patients (more symptom free, fewer with neurologic deficits). There has been a notable decrease in perioperative stroke caused by ischemia during clamping and intracerebral hemorrhage, but postoperative thrombosis and embolism remain the major cause of neurologic complications. Conclusions: Although patient selection seems toplay a role, most perioperative strokes were due to technical errors made during carotid endarterectomy or reconstruction and were preventable.

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Documento generato il 22/10/20 alle ore 13:03:06