Studies on Effectiveness of Endarterectomy in Treatment of Carotid Insufficiency

Abstract

Cerebral ischemia due to carotid artery disease is primarily a mechanical problem of obstruction to flow in the carotid system. Successful surgical treatment, therefore, must be directed toward relief of this obstruction. Critical evaluation of the surgical approach depends on adequate means of measuring the removal of the obstruction. Thirty-seven patients with symptomatic cervical carotid artery disease have been operated upon in the last 4 years in the University of Louisville Hospitals. Several methods have been utilized to measure the effectiveness of the carotid operations. An evaluation of these methods and a discussion of the problems involved in correlating the operative procedure with the clinical course of these patients constitute the purpose of this report. Preoperative Evaluation The presumptive diagnosis of carotid artery disease was confirmed in all patients by preoperative arteriography. In 16 patients bilateral lesions were suspected, and in these cases either bilateral carotid arteriograms or aortic archograms