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Abstract
Background. Aneurysmal degeneration of a carotid reconstruction was not recognized until the
patient, who was known to have recurrent carotid artery stenosis, had a thromboembolic
stroke. This sequelae of carotid endarterectomy is a serious complication, associated
with a high morbidity and mortality rate. This review was conducted to establish the
risk of transient ischemic attack and stroke for patients found to have recurrent
carotid stenosis associated with aneurysmal. degeneration of the carotid artery after
endarterectomy.
Methods. A case is reported, and 100 literature references of aneurysmal degeneration of the
carotid artery after endarterectomy were reviewed.
Results. False aneurysm from anastomotic disruption was the most common presentation identified
in the cases reviewed. Nineteen of the patients had a significant neurologic event;
however, three (50%) of six patients with aneurysm and recurrent carotid artery stenosis
had a transient ischemic attack or stroke.
Conclusions. The incidence of neurologic symptoms is markedly increased when recurrent carotid
artery stenosis is associated with carotid aneurysm. During postoperative surveillance
after endarterectomy, the identification of recurrent carotid artery stenosis requires
evaluation for aneurysmal degeneration of the carotid artery with duplex scanning.
These patients are at significant risk for transient ischemic attack and stroke. This
rare complication merits operative repair.
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Article info
Publication history
Accepted:
April 24,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.
