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Long-term progression of contralateral carotid artery disease after endarterectomy: is there a need for Duplex surveillance?

Asciutto, Giuseppe LU ; Wistrand, Jonatan LU ; Riva, L; Björses, Katarina LU ; Goncalves, Isabel LU and Dias, Nuno LU (2012) In International Angiology 31(4). p.361-367
Abstract
AIM:

The aim of this paper was to define the incidence of disease progression of the contralateral internal carotid artery (CICA) in patients undergoing carotid endarterectomy (CEA) and to identify factors influencing disease progression.



METHODS:

Patients from our primary catchment area that had undergone CEA between 2002 and 2005 were included. The study cohort was divided in four groups based on the preoperative stenosis grade (normal ICA <40%, N.=56; mild 40-60%, N.=41; moderate 61-80%, N.=12; severe 81-99%, N.=7). Patients initially planned or already submitted to contralateral CEA or with contralateral occlusion were excluded.



RESULTS:

One hundred and seventeen... (More)
AIM:

The aim of this paper was to define the incidence of disease progression of the contralateral internal carotid artery (CICA) in patients undergoing carotid endarterectomy (CEA) and to identify factors influencing disease progression.



METHODS:

Patients from our primary catchment area that had undergone CEA between 2002 and 2005 were included. The study cohort was divided in four groups based on the preoperative stenosis grade (normal ICA <40%, N.=56; mild 40-60%, N.=41; moderate 61-80%, N.=12; severe 81-99%, N.=7). Patients initially planned or already submitted to contralateral CEA or with contralateral occlusion were excluded.



RESULTS:

One hundred and seventeen patients were analysed. Disease progression occurred in 13 (11%) patients after a mean of 47.6 months (SD 1.6 months). A moderate preoperative CICA stenosis was associated with disease progression (P=0.017). Late neurologic events referable to the CICA independently of progression occurred in 13 (11%) patients. There were 4 (30.7%) events in the 13 carotids with progression and only 9 (7%) in the 117 without progression (P=0.060). .Moderate and severe preoperative CICA stenosis and renal insufficiency were associated with postoperative ipsilateral neurological symptoms (P=0.001 and 0.009, respectively).



CONCLUSION:

Disease progression of the CICA after CEA is not uncommon. The preoperative degree of CICA stenosis is related to subsequent disease progression and to the occurrence of symptoms. More studies are needed to identify risk factors influencing the progression of ICA disease. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Angiology
volume
31
issue
4
pages
361 - 367
publisher
Minerva Medica
external identifiers
  • wos:000309443800008
  • pmid:22801402
  • scopus:84867607206
ISSN
1827-1839
language
English
LU publication?
yes
id
59d9ad22-f2db-4b19-aefd-7f420ce7fdbe (old id 2967099)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22801402?dopt=Abstract
date added to LUP
2012-08-09 19:25:48
date last changed
2017-01-01 07:32:02
@article{59d9ad22-f2db-4b19-aefd-7f420ce7fdbe,
  abstract     = {AIM:<br/><br>
The aim of this paper was to define the incidence of disease progression of the contralateral internal carotid artery (CICA) in patients undergoing carotid endarterectomy (CEA) and to identify factors influencing disease progression.<br/><br>
<br/><br>
METHODS:<br/><br>
Patients from our primary catchment area that had undergone CEA between 2002 and 2005 were included. The study cohort was divided in four groups based on the preoperative stenosis grade (normal ICA &lt;40%, N.=56; mild 40-60%, N.=41; moderate 61-80%, N.=12; severe 81-99%, N.=7). Patients initially planned or already submitted to contralateral CEA or with contralateral occlusion were excluded.<br/><br>
<br/><br>
RESULTS:<br/><br>
One hundred and seventeen patients were analysed. Disease progression occurred in 13 (11%) patients after a mean of 47.6 months (SD 1.6 months). A moderate preoperative CICA stenosis was associated with disease progression (P=0.017). Late neurologic events referable to the CICA independently of progression occurred in 13 (11%) patients. There were 4 (30.7%) events in the 13 carotids with progression and only 9 (7%) in the 117 without progression (P=0.060). .Moderate and severe preoperative CICA stenosis and renal insufficiency were associated with postoperative ipsilateral neurological symptoms (P=0.001 and 0.009, respectively).<br/><br>
<br/><br>
CONCLUSION:<br/><br>
Disease progression of the CICA after CEA is not uncommon. The preoperative degree of CICA stenosis is related to subsequent disease progression and to the occurrence of symptoms. More studies are needed to identify risk factors influencing the progression of ICA disease.},
  author       = {Asciutto, Giuseppe and Wistrand, Jonatan and Riva, L and Björses, Katarina and Goncalves, Isabel and Dias, Nuno},
  issn         = {1827-1839},
  language     = {eng},
  number       = {4},
  pages        = {361--367},
  publisher    = {Minerva Medica},
  series       = {International Angiology},
  title        = {Long-term progression of contralateral carotid artery disease after endarterectomy: is there a need for Duplex surveillance?},
  volume       = {31},
  year         = {2012},
}