Severe bilateral carotid stenosis
Fraunhofer, S.; Kiossis, D.; Helmberger, H.; Von Sommoggy, S.; Maurer, P.C.
Journal des Maladies Vasculaires 18(3): 225-228
1993
ISSN/ISBN: 0398-0499 PMID: 8254246 Document Number: 414827
An analysis of the relevant data from the Veterans Affairs Cooperative Study Group in asymptomatic patients, showed that 26 of the 32 ipsilateral strokes occurred during the first two years of clinical follow-up. Furthermore, as observed in the medical group, half the neurologic outcome events were strokes and were not preceded by transient ischemic attacks. In the North American Symptomatic Carotid Endarterectomy Trial over a 2-year period, 45 percent of those with occlusion had a stroke compared to 15 percent in the surgical group. These data dispel the traditionally held view that patients with severe contralateral disease should not be subjected to surgery. However, the referral of patients to centers capable of low rates of surgical complications is essential in a plan that includes carotid endarterectomy with optimal medical management.