Effect of severe contralateral carotid stenosis or occlusion on early and late outcomes after carotid endarterectomy
10.4174/astr.2019.97.4.202
- Author:
Min Jae JEONG
1
;
Hyunwook KWON
;
Min Ju KIM
;
Youngjin HAN
;
Tae Won KWON
;
Yong Pil CHO
Author Information
1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ypcho@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Carotid endarterectomy;
Carotid stenosis;
Outcomes;
Stroke
- MeSH:
Carotid Stenosis;
Diabetes Mellitus;
Endarterectomy, Carotid;
Humans;
Incidence;
Mortality;
Multivariate Analysis;
Myocardial Infarction;
Perioperative Period;
Retrospective Studies;
Stroke;
Survival Rate
- From:Annals of Surgical Treatment and Research
2019;97(4):202-209
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We aimed to compare clinical outcomes after carotid endarterectomy (CEA) between Korean patients with and without severe contralateral extracranial carotid stenosis or occlusion (SCSO). METHODS: Between January 2004 and December 2014, a total of 661 patients who underwent 731 CEAs were stratified by SCSO (non-SCSO and SCSO groups) and analyzed retrospectively. The study outcomes included the occurrence of major adverse cardiovascular events (MACE), defined as stroke or myocardial infarction, and all-cause mortality during the perioperative period and within 4 years after CEA. RESULTS: There were no significant differences in the incidence of MACE or any individual MACE manifestations between the 2 groups during the perioperative period or within 4 years after CEA. On multivariate analysis to identify clinical variables associated with long-term study outcomes, older age (hazard ratios [HRs], 1.06; 95% confidence intervals [CIs], 1.03–1.09; P < 0.001) and diabetes mellitus (HR, 1.71; 95% CI, 1.14–2.57; P = 0.010) were significantly associated with an increased risk of MACE occurrence, while preexisting SCSO was not associated with long-term incidence of MACE and individual MACE components. Kaplan-Meier survival analysis showed similar MACE-free (P = 0.509), overall (P = 0.642), and stroke-free (P = 0.650) survival rates in the 2 groups. CONCLUSION: There were no significant differences in MACE incidence after CEA between the non-SCSO and SCSO groups, and preexisting SCSO was not associated with an increased risk of perioperative or long-term MACE occurrence.
