Comparative results of staged and simultaneous bilateral carotid endarterectomy: a clinical study and surgical treatment

Objective: Bilateral carotid stenoses are actually managed by staged endart erectomy, The present study compares the results of the above surgical proc edure with simultaneous bilateral carotid endarterectomy. Methods: Sixty-fo ur carotid endarterectomies were carried out on two groups of thirty-two pa tients with bilateral carotid stenoses, Fifteen patients (group A) were sub jected to staged and 17 patients (group B) who were subjected to simultaneo us bilateral carotid endarterectomies, Results: The mortality rate was zero in both groups; no statistically significant difference was found concerni ng complications related to the heart, neurological deficit and postoperati ve hypertension. Conclusions: Simultaneous carotid endarterectomy is a chal lenging and technically demanding operation but with limited indications in strictly selected patients. The development of methods of more effective m onitoring and protection of the cerebral cells might broaden the indication s of such a surgical tactic in the future. Staged carotid endarterectomy, h owever, remains the method of choice for the management of bilateral caroti d occlusive disease. (C) 2000 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.