Prevention of stroke during carotid endarterectomy

W. H. Edwards, J. M. Jenkins, W. H. Edwards, J. L. Mulherin

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    From 1976 through 1985, 2857 carotid reconstructive procedures were performed on 2087 patients. Postoperative neurologic deficit occurred in 59 patients (2.1%). Thirty one patients (1.2%) suffered deficits that were permanent while 25 patients (0.9%) cleared to be discharged normal. In the last 5 years of the study, an aggressive approach was taken in cases where the patient was noted to have a postoperative neurologic change. It is routine to allow the patient to awaken in the operating room and to perform a simple neurologic examination prior to transport to the recovery room. If a neurologic change occurs during the postoperative period, immediate exploration is undertaken without preliminary testing. With this policy, 20 patients underwent exploration of the operated carotid artery and six of these patients recovered completely. To reduce the stroke rate from carotid endarterectomy (CE), technical errors must be kept to a minimum. Prevention of hypoperfusion with a shunt and careful mobilization of the artery to prevent microembolization should be practiced. Postoperative thrombosis can be decreased by the routine use of platelet antiaggregates and the avoidance of perioperative hypotension. Reperfusion of injury can be minimized by control of postoperative hypertension and proper preoperative selection of patients. Postoperative neurologic deficit following CE remains a relatively rare event and consequently sufficient experience in the treatment of this problem is difficult to acquire.

    Original languageEnglish (US)
    Pages (from-to)125-128
    Number of pages4
    JournalAmerican Surgeon
    Volume54
    Issue number3
    StatePublished - Jan 1 1988

    Fingerprint

    Carotid Endarterectomy
    Stroke
    Neurologic Manifestations
    Nervous System
    Recovery Room
    Neurologic Examination
    Operating Rooms
    Reperfusion Injury
    Carotid Arteries
    Postoperative Period
    Hypotension
    Patient Selection
    Thrombosis
    Blood Platelets
    Arteries
    Hypertension

    All Science Journal Classification (ASJC) codes

    • Surgery

    Cite this

    Edwards, W. H., Jenkins, J. M., Edwards, W. H., & Mulherin, J. L. (1988). Prevention of stroke during carotid endarterectomy. American Surgeon, 54(3), 125-128.

    Prevention of stroke during carotid endarterectomy. / Edwards, W. H.; Jenkins, J. M.; Edwards, W. H.; Mulherin, J. L.

    In: American Surgeon, Vol. 54, No. 3, 01.01.1988, p. 125-128.

    Research output: Contribution to journalArticle

    Edwards, WH, Jenkins, JM, Edwards, WH & Mulherin, JL 1988, 'Prevention of stroke during carotid endarterectomy', American Surgeon, vol. 54, no. 3, pp. 125-128.
    Edwards WH, Jenkins JM, Edwards WH, Mulherin JL. Prevention of stroke during carotid endarterectomy. American Surgeon. 1988 Jan 1;54(3):125-128.
    Edwards, W. H. ; Jenkins, J. M. ; Edwards, W. H. ; Mulherin, J. L. / Prevention of stroke during carotid endarterectomy. In: American Surgeon. 1988 ; Vol. 54, No. 3. pp. 125-128.
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