PERIOPERATIVE STROKE AFTER CAROTID ENDARTERECTOMY - ETIOLOGIC RISK-FACTORS AND MANAGEMENT

291 patients were subjected to carotid endarterectomy from January 198 5 to June 1992 in two Australian medical institutions. Of the 291 pati ents, perioperative stroke occurred in 22 (6.3%) after 347 operations (moderate 17 and severe 5). The 22 patients were studied with Doppler scan, angiography, reexploration and CT. Reexploration showed that 12 of 14 patients had thrombosis in the internal carotid artery at operat ion. The etiological factors for perioperative strokes included thromb osis at the operative sites in 14 patients (64%), cerebral embolism af ter operation in 4, clamping ischemia in 2, intracerebral hemorrhage i n 1 and unknown cause in 1. Six patients (27%) recovered completely in 4 weeks, 10 (45%) had mild residual neurological deficits, 5 (23%) ha d moderate neurological deficits and 1 died 3 days after operation. On ly 6 patients had permanent neurological deficits (6 / 347, 17%).