The Effect of Contralateral Carotid Occlusion in Patients Undergoing Carotid Artery Endarterectomy

Authors

  • Luis Duarte-Gamas Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal
  • António Pereira-Neves Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal; Department of Biomedicine – Unit of Anatomy, Faculdade de Medicina da Universidade do Porto, Portugal
  • Filipa Jácome Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal;
  • Diogo Domingues-Monteiro Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal;
  • João P. Rocha-Neves Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal; Department of Biomedicine – Unit of Anatomy, Faculdade de Medicina da Universidade do Porto, Portugal

DOI:

https://doi.org/10.48750/acv.419

Keywords:

Carotid arterial disease, Carotid endarterectomy

Abstract

INTRODUCTION: Contralateral carotid occlusion (CCO) is considered a high-risk condition for patients undergoing carotid artery endarterectomy (CEA). Patients with a CCO may be intolerant to carotid cross-clamping during CEA, thus prone to postoperative adverse neurological outcomes. Patients with CCO may also have a higher burden of atherosclerotic disease, leading to a higher rate of cardiovascular events.

METHODS: A Medline search was performed in order to identify publications focused on the impact of CCO on outcomes after CEA.

RESULTS: Patients with CCO present a higher incidence of intolerance to carotid cross-clamping. The rates of shunt use are higher in patients with CCO. In the postoperative period, patients with CCO show a higher rate of stroke. Evidence regarding the effect of CCO on long-term outcomes remains controversial, with most studies reporting a lack of association between CCO and adverse long-term outcomes after CEA.

CONCLUSION: Patients with CCO have an increased risk of postoperative adverse outcomes. The best strategy for this group of patients should be based on a case-by-case approach.

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References

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Published

2022-07-01

How to Cite

1.
Duarte-Gamas L, Pereira-Neves A, Jácome F, Domingues-Monteiro D, Rocha-Neves JP. The Effect of Contralateral Carotid Occlusion in Patients Undergoing Carotid Artery Endarterectomy. Angiol Cir Vasc [Internet]. 2022 Jul. 1 [cited 2022 Aug. 18];18(1):30-5. Available from: https://acvjournal.com/index.php/acv/article/view/419

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Review Article