Carotid endarterectomy without protective measures in patients with occluded and non occluded contralateral carotid artery

Background. Comparison of carotid endarterectomy in patients with and witho ut occluded contralateral carotid artery. Methods. Design: evaluation of results without using shunt or patch. Settin g: "Aretaeion" Hospital, Medical School, University of Athens. Subjects: 23 5 patients, divided into group I of 40 patients with and group II: of 195 p atients without occluded contralateral carotid artery. Intervention: caroti d endarterectomy under general anesthesia. Main outcome measures: heparin a dministration, stable hemodynamic status during clamping, short duration mo nitoring postoperatively. Results. Postoperative morbidity of both groups was 2.5% (6/235) and mortal ity 1.7% (4/235). Group I: mortality rate was 2.5% (1/40) major and minor s troke each 2.5% (1/40) and group II: 1.5% (3/195) and 1% (2/195) respective ly (NS). Four to 108 months later, 30% (12/40) of group I and 21% (41/195) of group II died. Conclusions Endarterectomy of the carotid artery under general anesthesia w ithout use of shunt and patch in patients with or without occlusion of the contralateral carotid artery presented the same comparative results. Candid ates for carotid endarterectomy should be screened systematically for coron ary disease preoperatively and annual stress testing postoperatively, tacti cs which may Improve early and late mortality rate after carotid surgery.