Carotid endarterectomy
In medicine, carotid endarterectomy, or CEA, is "excision of the thickened, atheromatous tunica intima of a carotid artery."[1]
Effectiveness
CEA can benefit patients with[2] and without[3] symptoms according to systematic reviews by the Cochrane Collaboration.
Preoperative assessment
The preoperative care includes assessment for coronary heart disease. In one study, 40% of patients had coronary heart disease, with 18% of the patients (or 48% of those with coronary heart disease) had severe disease (obstruction of the left main or three of the arteries).[4] The strongest predictor of coronary heart disease was the presence of diabetes mellitus. The presence of bilateral carotid disease was not a significant prediction of coronary disease. The presence of cardiac symptoms probably increasess the likelihood of coronary disease.[5]
References
- ↑ Anonymous (2024), Carotid endarterectomy (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Cina CS, Clase CM, Haynes RB (2000). "Carotid endarterectomy for symptomatic carotid stenosis". Cochrane Database Syst Rev (2): CD001081. DOI:10.1002/14651858.CD001081. PMID 10796411. Research Blogging.
- ↑ Chambers BR, Donnan GA (2005). "Carotid endarterectomy for asymptomatic carotid stenosis". Cochrane Database Syst Rev (4): CD001923. DOI:10.1002/14651858.CD001923.pub2. PMID 16235289. Research Blogging.
- ↑ Shimada T, Toyoda K, Inoue T, et al (October 2005). "Prediction of coronary artery disease in patients undergoing carotid endarterectomy". J. Neurosurg. 103 (4): 593–6. PMID 16266039. [e]
- ↑ Chimowitz MI, Weiss DG, Cohen SL, Starling MR, Hobson RW (April 1994). "Cardiac prognosis of patients with carotid stenosis and no history of coronary artery disease. Veterans Affairs Cooperative Study Group 167". Stroke 25 (4): 759–65. PMID 8160217. [e]