RISK OF EARLY CONTROLATERAL CAROTID ENDARTERECTOMY

Between January 1984 and January 1994, we performed early endarterecto my of the controlateral carotid on 94 patients within a delay of 1 to 8 days after the first endarterectomy. Lesions were symptomatic in 58 patients (62%) and asymptomatic in 36 patients (38%). Eighty-four oper ations were performed under cervical block anesthesia (89%), eight und er general anesthesia, and two under local anesthesia (2%). Severe int raoperative hypertension occurred in seven patients (7%) including fiv e under cervical block anesthesia (6%) and two under general anesthesi a (25%). Two patients (2.1%) died of stroke secondary to carotid throm bosis in one case and hyperperfusion syndrome in one case. Morbidity i ncluded one transient ischemic attack (1%) and one myocardial infarcti on (1%). Postoperative control of patency revealed asymptomatic occlus ion of the internal carotid artery in two patients, accounting for one of the two deaths. Our findings demonstrate that neurologic mortality /morbidity is not higher after early controlateral carotid endarterect omy than unilateral endarterectomy.