Recurrent XXXX . Results and complications of 57 operations.

@entity1 @entity1373 @entity256 @entity439 @entity1031 @entity731 @entity850 @entity543 @entity715
Among 1992 @entity1 undergoing carotid endarterectomy from January 1972 through December 1984, 57 operations were performed in 51 @entity1 for recurrent @entity543 . Thirty-four of these cases had undergone initial surgery at this institution while 23 had endarterectomy elsewhere. Fifty-two of the 57 operations were for symptomatic disease while five were for evidence of a progressing lesion. All operative procedures were monitored with intracerebral blood flow measurements and continuous electroencephalograms. Twenty-three @entity1 required intraoperative shunting. There were no complications related to shunt usage or to the period of temporary occlusion in @entity1 who did not require shunting. Recurrent @entity850 was related to intimal @entity1373 in 14 cases, recurrent @entity731 with interluminal thrombi or degenerated plaque in 27, unexplained soft @entity715 in eight, proximal scarring in six, and to @entity439 in two. Intimal @entity1373 was the most common cause for @entity256 within 2 years from the date of surgery and developed earlier in @entity1 with a primary closure than in @entity1 closed with a patch graft. The operative complication rate was 10.5% or 4 times the risk of surgery for primary @entity731 at this institution. Complications were attributed primarily to intraoperative and postoperative @entity1031 events related to apparent increased thrombogenicity of these vessels. The highest complication rate occurred in the group of @entity1 undergoing surgery for thrombotic material in the internal carotid artery, either primary or with underlying @entity731 . There were no neurological complications in the group with @entity1373 . The authors' experience suggests that on-lay patch grafting without endarterectomy should be used in @entity1 with @entity1373 . @entity1 with complicated recurrent @entity731 can be treated with endarterectomy and patch grafting, but interposition vein grafts should be considered in cases in which the vessels are extensively damaged by the recurrent plaque or with an unexplained @entity715 at the site of previous endarterectomy.
