Karotis Endarterektomi Sonrası Klinik Sonuçlar ve Orta Dönem Mortalite: Tek Merkez Çalışması

Year 2023, Volume: 33 Issue: 5, 614 - 618, 25.10.2023

Emre Yasar , Muhammed Bayram

https://doi.org/10.54005/geneltip.1330055

Abstract

Amaç: Bu tek merkezli çalışma, çeşitli endikasyonlar için karotis endarterektomi (CEA) uygulanan hastalarda klinik sonuçları ve orta dönem mortaliteyi araştırmayı amaçlamıştır.
Gereç ve Yöntemler: Çalışma, kurumumuzda CEA uygulanan 109 hastayı içermektedir. Demografik özellikler, cerrahi endikasyonlar, operasyon teknikleri ve erken postoperatif komplikasyonlar kaydedilmiştir. Ortalama 23.3 ± 17.2 aylık takip verileri elde edilmiş ve mortalite nedenleri ve nörolojik sonuçlar analiz edilmiştir.
Bulgular: Hastaların ortalama yaşı 66.53 ± 8.00 yıldır ve 73 erkek ile 36 kadın bulunmaktadır. CEA endikasyonları, hastaların %21.1'inde geçici iskemik atak (TIA) ve %26.6'sında iskemik inme öyküsüdür. Genel olarak, hastaların %86.2'sinde ipsilateral karotis darlığı %70 veya daha fazladır. Hastaların çoğuna (%89.9) genel anestezi altında ameliyat uygulanmış olup, en yaygın kullanılan cerrahi teknik geleneksel karotis endarterektomidir (%78.0). Longitudinal karotis arteriyotomisinin en sık kullanılan rekonstrüksiyon yöntemi Dacron yama plastisidir (%56.0). Erken takip döneminde düşük hastane mortalitesi (%0.9) ve sınırlı postoperatif komplikasyonlar tespit edilmiştir (%3.7 TIA, %1.8 büyük nörolojik komplikasyonlar ve %1.8 küçük nörolojik komplikasyonlar). Takip döneminde, mutlak sağkalım oranı %87.0 olarak belirlenmiştir.
Sonuç: Çalışmamız, CEA sonrası olumlu erken sonuçları ve kabul edilebilir uzun dönem mortalite oranlarını göstermektedir. Ancak, bu sonuçları desteklemek ve CEA'nın uzun dönem faydalarını daha iyi anlamak için daha büyük ve çok merkezli çalışmalara ihtiyaç vardır.

Keywords

karotis arter hastalıkları, endarterektomi, mortalite, inme

Clinical Outcomes and Midterm Mortality After Carotid Endarterectomy: A Single Center Study

Abstract

Background/Aims: This single-center study aimed to investigate the clinical outcomes and midterm mortality in patients who underwent carotid endarterectomy (CEA) for various indications.
Methods: The study included 109 patients who underwent CEA at our institution. Demographic characteristics, indications for surgery, operative techniques, and early postoperative complications were recorded. Follow-up data were obtained for a mean period of 23.3 ± 17.2 months, and mortality causes, and neurological outcomes were analysed.
Results: The mean age of the patients was 66.53 ± 8.00 years, with 73 men and 36 women. Indications for CEA included transient ischemic attack (TIA) in 21.1% and a history of ischemic stroke in 26.6% of patients. Overall, 86.2% had ipsilateral carotid stenosis of 70% or more. Most patients (89.9%) were operated under general anesthesia, and the conventional carotid endarterectomy technique was most employed (78.0%). The most frequent reconstruction method for the longitudinal carotid arteriotomy was Dacron patch plasty (56.0%). Early follow-up revealed low hospital mortality (0.9%) and limited postoperative complications (3.7% TIA, 1.8% major neurological complications, and 1.8% minor neurological complications). During the follow-up period, absolute survival was 87.0%.
Conclusions: Our study demonstrates favourable early outcomes and acceptable long-term mortality rates following CEA. However, larger, and multicentre studies are warranted to further validate these results and enhance our understanding of CEA's long-term benefits

Keywords

carotid artery stenosis, endarterectomy, mortality, stroke

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