Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2018
Influence of Contralateral Carotid Occlusion on Outcomes After Carotid Endarterectomy: A Meta-Analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод пока не подготовлен
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Cheng Wenlong, Lu Huijun, Hu Yali
Аннотация
BACKGROUND: There is a controversy about whether the contralateral carotid occlusion (CO) in patients undergoing carotid endarterectomy (CEA) is associated with worse early and long-term outcomes. The aim of this systematic review and meta-analysis was to investigate the impact of CO on outcomes after CEA.
METHODS: PubMed, Embase, and MEDLINE databases were searched until January 2018 for studies comparing early and long-term outcomes of CEA in patients with CO and with patent contralateral carotid (CP). Two independent reviewers identified studies meeting our inclusion/exclusion criteria, extracted relevant data and assessed quality. Fixed- or random-effects models were used to calculate the overall effect estimates.
RESULTS: Our literature search identified 35 articles eligible for inclusion in the review and analysis. Patients with CO had higher rate of preoperative symptoms (Stroke + transient ischemic attack [TIA]) (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.11-1.31) and had increased risk of perioperative neurological complications (Stroke + TIA) (OR = 1.63, 95% CI: 1.36-1.94) compared with those with CP. No significant difference in the perioperative mortality rate (OR = 1.40, 95% CI: .99-1.98) and the stroke-free survival rate at 5 years (OR = 1.06, 95% CI: .79-1.40) between 2 groups was identified.
CONCLUSIONS: The presence of CO results in higher rate of preoperative symptoms and increases perioperative risk of neurological complications in CEA, but do not have a significant impact on the perioperative mortality rate and the stroke-free survival rate at 5 years. Careful consideration should be given in perioperative care in these patients.
METHODS: PubMed, Embase, and MEDLINE databases were searched until January 2018 for studies comparing early and long-term outcomes of CEA in patients with CO and with patent contralateral carotid (CP). Two independent reviewers identified studies meeting our inclusion/exclusion criteria, extracted relevant data and assessed quality. Fixed- or random-effects models were used to calculate the overall effect estimates.
RESULTS: Our literature search identified 35 articles eligible for inclusion in the review and analysis. Patients with CO had higher rate of preoperative symptoms (Stroke + transient ischemic attack [TIA]) (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.11-1.31) and had increased risk of perioperative neurological complications (Stroke + TIA) (OR = 1.63, 95% CI: 1.36-1.94) compared with those with CP. No significant difference in the perioperative mortality rate (OR = 1.40, 95% CI: .99-1.98) and the stroke-free survival rate at 5 years (OR = 1.06, 95% CI: .79-1.40) between 2 groups was identified.
CONCLUSIONS: The presence of CO results in higher rate of preoperative symptoms and increases perioperative risk of neurological complications in CEA, but do not have a significant impact on the perioperative mortality rate and the stroke-free survival rate at 5 years. Careful consideration should be given in perioperative care in these patients.