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 

机构地区：[1]Department of Cardiovascular Diseases,Mayo Clinic,Rochester,Minnesota,USA [2]Radiology,Mayo Clinic,Rochester,Minnesota,USA [3]Radiology,Azienda Ospedaliero Universitaria,Cagliari,Italy [4]Neurosurgery,Mayo Clinic,Rochester,Minnesota,USA

出　　处：《Stroke & Vascular Neurology》2022年第3期251-257,共7页卒中与血管神经病学（英文）

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 series.All patients who underwent CEA for unilateral anterior circulation cerebrovascular events with ipsilateral<50%carotid stenosis from 2002 to 2020 were included.Imaging 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 assessed.The presence of vulnerable plaque characteristics was compared between arteries ipsilateral to the ischaemic event and contralateral arteries.The prevalence of perioperative/intraoperative complications,as well as recurrent ischaemic events at follow-up was determined.Results Thirty-two patients were included in the analysis,of which 25.0%were female.Carotid arteries ipsilateral to an ischaemic event had a significantly higher prevalence of IPH when compared with contralateral arteries(80.0%vs 0.0%;p<0.001).There were no intraoperative complications.One patient(3.1%)developed symptoms of transient ipsilateral ischaemia 1 day following CEA which resolved without treatment.In 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 events.Conclusion CEA appears to be safe and well-tolerated in patients with SyNC.Additional studies with larger cohorts and longer follow-up intervals are needed in order to determine the role of CEA in this patient population.

关 键 词：PATIENTS CAROTID prevention 

分 类 号：R543.4[医药卫生—心血管疾病]