What are the most serious perioperative complications?
The most serious perioperative complications of
carotid surgery are neurologic or cardiac. Neurologic complica-tions include
cerebral infarction, transient ischemia, and cognitive dysfunction. Ischemic
cerebral injury may result from embolization of thrombus or air during surgical
manipulation. It may also result from decreased cerebral perfusion during
temporary carotid artery occlusion during surgery. Arterial stenosis or
occlusion after CEA may also produce an ischemic insult. A stroke-related
morbidity of 2–3% for CEA is considered acceptable.
Patients with atherosclerotic disease of the
carotid arteries often also have similar pathology of the coronary vessels. A
perioperative incidence of myocardial infarction of 5% is considered
acceptable.
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