Medical complications associated with carotid endarterectomy

被引:100
作者
Paciaroni, M
Eliasziw, M
Kappelle, LJ
Finan, JW
Ferguson, GG
Barnett, HJM
机构
[1] Univ Western Ontario, John P Robarts Res Inst, London, ON N6A 5K8, Canada
[2] Univ Western Ontario, Dept Epidemiol & Biostat, London, ON N6A 5K8, Canada
[3] Univ Western Ontario, Dept Clin Neurol Sci, London, ON N6A 5K8, Canada
关键词
carotid endarterectomy; clinical trials; complications;
D O I
10.1161/01.STR.30.9.1759
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Carotid endarterectomy (CE) has been shown to be beneficial in patients with symptomatic high-grade (70% to 99%) internal carotid artery stenosis. To achieve this benefit, complications must be kept to a minimum. Complications not associated with the procedure itself, but related to medical conditions, have received little attention. Methods-Medical complications that occurred within 30 days after CE were recorded in 1415 patients with symptomatic stenosis (30% to 99%) of the internal carotid artery. They were compared with 1433 patients who received medical care alone. All patients were in the North American Symptomatic Carotid Endarterectomy Trial (NASCET). Results-One hundred fifteen patients (8.1%) had 142 medical complications: 14(1%) myocardial infarctions, 101 (7.1%) other cardiovascular disorders, 11 (0.8%) respiratory complications, 6 (0.4%) transient confusions, and 10 (0.7%) other complications. Of the 142 complications, 69.7% were of short duration, and only 26.8% prolonged hospitalization. Five patients died: 3 from myocardial infarction acid 2 suddenly. Medically treated patients experienced similar complications with one third the frequency. Endarterectomy was approximate to 1.5 times more likely to trigger medical complications in patients with a history of myocardial infarction, angina, or hypertension (P<0.05). Conclusions-Perioperative medical complications were observed in slightly fewer than 1 of every 10 patients who underwent CE. The majority of these complications completely resolved. Most complications were cardiovascular and occurred in patients with 1 or more cardiovascular risk factors. In this selected population, the occurrence of perioperative myocardial infarction was uncommon.
引用
收藏
页码:1759 / 1763
页数:5
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