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PubMed1979

The stroke syndrome of long intraluminal clot with incomplete vessel obstruction.

A stroke syndrome is described in 3 patients where long intraluminal clot formation with incomplete vessel obstruction was seen angiographically. The vessel involved in 2 cases were carotid arteries and in the third a vertebral artery. The intervening phase of long clot formation may be a feature of many cases of complete vessel occlusion. The common features of the syndrome were vessel tenderness (carotidynia in 2 cases, and vertebral artery tenderness in the third), vascular headache, the presence of subintimal haemorrhage as an anchor point for the clot, and the recurrence of clinical events. Surgical removal of these clots were successfully undertaken in each case at the acute stage.

Adult↗
PubMed1997

[Embolism detection after carotid endarterectomy].

Embolic phenomena, early after endarterectomy of the internal carotid artery, were observed in 8 of 28 cases. No patient suffered from ischemic events. 24 h later, no further embolic signals could be detected. These and other observations of an increased risk of perioperative thrombosis and cerebral infarction, in the case of persistent embolic signals during the early recovery period, confirm the probably important role of the transcranial emboli detection in the monitoring of carotid surgery.

Aged↗
PubMedDate not supplied

Morbidity and mortality following carotid surgery.

The records of 920 patients who underwent carotid endarterectomy by the same surgeon (M. D'A) between 1976 and 1989 were reviewed. Particular attention was paid to both the neurological and general complications and to how and when the neurological symptoms appeared. Among these patients, a cumulative stroke plus death rate of 3.1% was observed. Complications were classified as clamping ischemia (2.2%), postoperative embolism (1.5%), postoperative thrombosis (2.4%), and cerebral haemorrhage (0.3%). Two patients (0.2%) died from myocardial infarction. In 3.5% of patients, neurological symptoms were transient. The incidence of clamping ischemia was higher when 40 mmHg was considered as the safety limit of the back-pressure; this incidence fell by raising this limit to 50 mmHg, and introducing, in recent years, SEPs monitoring. Intraoperative monitoring of SEPs, in fact, reduced the neurological complications to 1.4%, while intraoperative angiography reduced the need for intraoperative reoperation from 10% to 2%. The use of antiplatelet drugs and an accurate surgical technique are useful steps in the prevention of postoperative embolism or thrombosis.

Cerebrovascular Disorders↗