Carotid artery endarterectomy in patients with symptomatic non-stenotic carotid artery disease

作     者：Valentina Nardi John C Benson Anthony S Larson Waleed Brinjikji Luca Saba Fredric B Meyer Giuseppe Lanzino Amir Lerman Luis E Savastano 

作者机构：Department of Cardiovascular DiseasesMayo ClinicRochesterMinnesotaUSA RadiologyMayo ClinicRochesterMinnesotaUSA RadiologyAzienda Ospedaliero UniversitariaCagliariItaly NeurosurgeryMayo ClinicRochesterMinnesotaUSA 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2022年第7卷第3期

页      面：251-257页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：patients carotid prevention 

摘      要：Object We sought to determine the safety and efficacy in secondary stroke prevention of carotid endarterectomy(CEA)in patients with symptomatic non-stenotic carotid artery disease(SyNC).Methods This was a single-centre retrospective case *** patients who underwent CEA for unilateral anterior circulation cerebrovascular events with ipsilateral50%carotid stenosis from 2002 to 2020 were *** hallmarks including the degree of luminal stenosis and the presence of various vulnerable plaque characteristics(eg,intraplaque haemorrhage(IPH)on MR angiography,ulceration or low-density plaque on CT angiography)were *** presence of vulnerable plaque characteristics was compared between arteries ipsilateral to the ischaemic event and contralateral *** prevalence of perioperative/intraoperative complications,as well as recurrent ischaemic events at follow-up was *** Thirty-two patients were included in the analysis,of which 25.0%were *** arteries ipsilateral to an ischaemic event had a significantly higher prevalence of IPH when compared with contralateral arteries(80.0%vs 0.0%;p0.001).There were no intraoperative *** patient(3.1%)developed symptoms of transient ipsilateral ischaemia 1 day following CEA which resolved without *** a median follow-up of 18.0 months(IQR 5.0-36.0),only one patient(3.1%)experienced a transient neurologic deficit with complete resolution(annualised rate of recurrent stroke after CEA of 1.5%for a total follow-up of 788 patient-months following CEA).All other patients(31/32,96.9%)were free of recurrent ischaemic *** CEA appears to be safe and well-tolerated in patients with *** studies with larger cohorts and longer follow-up intervals are needed in order to determine the role of CEA in this patient population.