Bilateral one-stage carotid endarterectomy--Is there an indication?

Abstract

Introduction (see Fig. 1). The patient was admitted urgently, commenced on intravenous heparin and underwent biThe indications for carotid endarterectomy (CEA) in lateral carotid endarterectomy as a single stage procedure under general anaesthesia. Shunts and dasymptomatic disease are established but may be refined in the future. Although CEA has been shown to cron patches were used on both sides. The patient made an uneventful recovery and was discharged confer benefit in asymptomatic patients with stenoses >70%, the results of the European Asymptomatic from hospital on the third postoperative day. Duplex assessment at 6 weeks showed both internal carotids Carotid Surgery Trial (ACST) are awaited. Bilateral carotid endarterectomy (BCE) can be performed either to be widely patent and the patient remains symptom free one year after his operation. as a one-stage procedure or in two stages. Although small series have reported satisfactory results with BCE performed as a one-stage procedure, these series invariably involved asymptomatic patients for whom Discussion CEA would not be currently advocated. We wish to report one-stage BCE performed for bilateral crescendo Currently CEA is recommended for symptomatic distransient ischaemic attacks (TIAs). ease where it has shown to be cost effective. Ac-