CAROTID ENDARTERECTOMY WITH AN OCCLUDED CONTRALATERAL CAROTID-ARTERY

Five hundred twenty-six patients who underwent carotid endarterectomy were separated by reviewing those 81 (15%) patients with an occluded c ontralateral carotid artery and those 445 (85%) with nonocclusion. The population characteristics and surgical indications were similar betw een the occluded and nonoccluded groups. Ipsilateral plus contralatera l perioperative stroke occurred during 11 of 445 operations (2.5%) in which the contralateral carotid was patent, and during which no patien t was hemorrhagic. Those patients with contralateral artery occlusion had ipsilateral plus contralateral stroke in 4 of 81 cases (4.9%) (NS) . Intracerebral hemorrhage was responsible for two of four strokes aft er carotid endarterectomy with contralateral occlusion (p = 0.001). Re stenosis to greater than 50% by duplex scanning was more rapid in the occluded group with primary closure (no patch) (p = 0.025) and for men (p = 0.025). Although perioperative safety is comparable, patients wi th contralateral carotid occlusion may have a greater risk of intracra nial hemorrhage and a more rapid rate of restenosis in some subgroups.