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Symptomatic recurrent carotid stenosis and aneurysmal degeneration after endarterectomy. Surgery 1993 May;113(5):580-6

Date

05/01/1993

Pubmed ID

8488479

Scopus ID

2-s2.0-0027193365   16 Citations

Abstract

BACKGROUND: Aneurysmal degeneration of a carotid reconstruction was not recognized until the patient, who was known to have recurrent carotid artery stenosis, had a thromboembolic stroke. This sequelae of carotid endarterectomy is a serious complication, associated with a high morbidity and mortality rate. This review was conducted to establish the risk of transient ischemic attack and stroke for patients found to have recurrent carotid stenosis associated with aneurysmal degeneration of the carotid artery after endarterectomy.

METHODS: A case is reported, and 100 literature references of aneurysmal degeneration of the carotid artery after endarterectomy were reviewed.

RESULTS: False aneurysm from anastomotic disruption was the most common presentation identified in the cases reviewed. Nineteen of the patients had a significant neurologic event; however, three (50%) of six patients with aneurysm and recurrent carotid artery stenosis had a transient ischemic attack or stroke.

CONCLUSIONS: The incidence of neurologic symptoms is markedly increased when recurrent carotid artery stenosis is associated with carotid aneurysm. During postoperative surveillance after endarterectomy, the identification of recurrent carotid artery stenosis requires evaluation for aneurysmal degeneration of the carotid artery with duplex scanning. These patients are at significant risk for transient ischemic attack and stroke. This rare complication merits operative repair.

Author List

Bergamini TM, Seabrook GR, Bandyk DF, Towne JB

Author

Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aneurysm
Carotid Stenosis
Cerebrovascular Disorders
Endarterectomy, Carotid
Humans
Ischemia
Male
Middle Aged
Recurrence
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc