[Early neurological complications after internal carotid endarterectomy]. / Wczesne powiklania neurologiczne po operacjach udroznienia tetnic szyjnych.

ABSTRACT

BACKGROUND AND PURPOSE: Stenosis of internal carotid arteries is one of the leading causes of ischemic stroke. Surgical restoration of arterial patency is the primary therapeutic method, aimed to prevent future ischemic stroke. This treatment mode is mainly reserved for patients with recurrent stenoses of internal carotid artery. Endarterectomy of internal carotid artery poses some risk of complications, and neurological complications are among the most dangerous ones. The purpose of the study was to assess early neurologic complications after surgical reopening of the affected arteries. MATERIAL AND METHODS: The study included 119 patients being operated because of critical stenosis of an internal carotid artery in the Department of General and Vascular Surgery of the Provincial Specialist Hospital in Olsztyn between 1999 and 2003. The main indications for surgical treatment were episodes of sustained cerebral ischemia and stenosis of an internal carotid artery exceeding 70%, documented with the ultrasound or angiographic examination. RESULTS: Neurologic complications occurred in 16 patients (12%). Ischemic stroke occurred in 6 cases, transient ischemic attacks in 4 cases, acute cerebral hyperemia in one case and four patients suffered from transient cranial nerve palsy. The most important risk factors of complications were a previous episode of cerebral ischemia, significant stenosis of a contralateral artery, nicotinism, arterial hypertension and coronary artery disease. Females are exposed to a significantly greater risk of complications. CONCLUSIONS: Surgical reopening of internal carotid arteries is a relatively safe therapeutic method with a modest risk of neurological complications, with the most dangerous and potentially lethal ischemic stroke occurring relatively rarely.