Pb. Dimakakos et al., Comparative results of staged and simultaneous bilateral carotid endarterectomy: a clinical study and surgical treatment, CARDIOV SUR, 8(1), 2000, pp. 10-17
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.