連続100例の無症候性内頸動脈狭窄症に対する頸動脈血栓内膜摘除術(CEA)の手術成績  [in Japanese] Surgical Results of Carotid Endarterectomy for Asymptomatic Carotid Stenosis: 100 Consecutive Cases  [in Japanese]

We performed the CEA for 100 consecutive patients of asymptomatic carotid stenosis from May 1993 to December 2004. There were 81 men and 19 women (48-83 years old) with a mean age of 69. The high cervical lesion (distal end is higher than C2 vertebral body) was recognized in 14 patients and contralateral occlusion was seen in 12 pacients. Five patients were over 80 years old. Fifty-five patients had coronary heart disease, and 21 patients received coronary artery bypass. Another 21 patients had percutaneous coronary intervention before CEA. Of the 42 patients treated for coronary artery disease, 16 patients had no history of previous ischemic heart attack. The electroencephalogram and the flow of internal shunt were monitored during operation. Although perioperative morbidity was 2% and there was no mortality, transient complications were recognized. Two patients had transient hemiparesis; 8 had cranial nerve palsy; 1 had postoperative arteriovenous fistula; 1 had mild acute myocardial infarction; 2 had wound infections; and there were 4 hematomas (2 operations). To minimize complications, preoperative examination of the coronary artery disease, meticulous operative procedures and prevention of hyperperfusion syndrome are important.