Carotid endarterectomy: long-term ultrasonic evaluation
Rohr-Le Floch, J.; Frey, E.; Hillion, C.; Gauthier, G.
Revue Neurologique (Paris) 144(5): 332-337
1988
ISSN/ISBN: 0035-3787 PMID: 3047839 Document Number: 311384
Among 128 patients operated for atherosclerosis of the internal carotid artery, 83 (59 males, 24 females, mean age 64 years) were controlled by Doppler ultrasonography, spectral analysis and Duplex. They had been submitted to 86 endarterectomies and 5 operations for total occlusion. In 23 cases, the stenosis was asymptomatic. The delay between operation and control varied between 12 and 123 months (mean follow-up: 50.6 months). 75 patients remained asymptomatic, whereas 8 suffered TIAS. Ultrasound examinations revealed 57 normal arteries or with thickened walls (62.6 p. 100), 9 stenoses less than 50 p. 100 (10 p. 100), 14 stenoses more than 50 p. 100 (15 p. 100) among which 8 were reoperated and 11 occlusions (4 failures of desocclusion and 7 postoperative occlusions: 7.6 p. 100). Recurrent stenoses occurred more frequently in females, mean age lower than in the whole group, as has been already reported. They determined minor symptomatology (vertebro-basilar insufficiency in 2 cases, TIA in 1 case). Three postoperative occlusions were acute and gave rise to a severe neurological deficit, whereas the other ones remained generally asymptomatic. These results are compared to reported series. Ultrasonography is a technique of choice to follow endarterectomised patients. The high rate of recurrent stenoses after endarterectomy raises questions about endarterectomy.