2014年3月
Long-term Morbidity and Mortality of Carotid Endarterectomy in Patients with End-stage Renal Disease Receiving Hemodialysis
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
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- 巻
- 23
- 号
- 3
- 開始ページ
- 545
- 終了ページ
- 549
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1016/j.jstrokecerebrovasdis.2013.05.012
- 出版者・発行元
- ELSEVIER SCIENCE BV
Background and Purpose: Renal insufficiency is a known risk factor for stroke. However, the impact of carotid endarterectomy (CEA) on stroke incidence in patients requiring dialysis remains controversial. We hypothesized that patients undergoing dialysis have no greater risk for periprocedural adverse events. Methods: We performed a retrospective chart review of 12 CEA patients who were on dialysis at the time of CEA. The charts were reviewed for patient demographics, systemic vascular disease, perioperative morbidity and mortality rates, and long-term outcome. Outcomes were recorded in terms of modified Rankin Scale (mRS). Results: The mean patient age at the time of CEAwas 66.9 +/- 7.3 years, with 1 patient having received carotid artery stenting for restenosis. Of the 12 patients undergoing 15 CEAs while being dialysis dependent, none exhibited periprocedural complications including stroke and myocardial infarction. During the follow-up period (mean, 56.1 +/- 38.8 months), 3 patients had strokes unrelated to the target vessels for CEA, and 3 patients died from acute myocardial infarction, congestive heart failure, and sepsis. The calculated 5-year survival rate in our series was 58.3% in all cases, 40.0% in symptomatic patients, and 71.4% in asymptomatic patients. Eight patients (66.6%) had a good outcome. Conclusions: These data suggest that patients undergoing dialysis were at no greater risk for periprocedural complications when undergoing CEA. Thus, CEA may be effective for stroke prevention in hemodialysis patients.
- リンク情報
- ID情報
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- DOI : 10.1016/j.jstrokecerebrovasdis.2013.05.012
- ISSN : 1052-3057
- eISSN : 1532-8511
- PubMed ID : 23830959
- Web of Science ID : WOS:000333053900039