Artikel
STA-MCA bypass for carotid occlusion can improve NIHSS
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Veröffentlicht: | 13. Mai 2014 |
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Gliederung
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Objective: The carotid occlusion surgery study (COSS) showed no benefit in stroke rate compared to medical treatment in a multicenter randomized study. Neurological comparison after bypass was not described. We analyzed our consecutive post COSS series of STA-MCA bypasses for carotid occlusion in a specialized single center operated by one surgeon.
Method: 10 consecutive patients (post COSS) were treated with a STA-MCA bypass for unilateral carotid occlusion with recurrent strokes and/or focal neurological symptoms. Patients were followed from 2011 with pre- and postoperative PET staging, duplex ultrasound as well as MRI imaging.
Results: The mean age was 66.7 years. The series included 8 male and 2 female patients. Peri- and postoperative stroke rate (until last follow-up) was 0 for all patients, a single TIA was reported in 2 patients each. PET criteria improved in 3 patients. Modified ranking scale improved from 2.0 to 1.5. NIHSS score improved from 4.2 to 1.9 (p=0.027). The analysis was performed using SPSS 21 (IBM, Armonk, USA).
Conclusions: Stroke rates can be reduced to a very low number in a specialized single center setting in well selected cases. STA-MCA bypass may have a positive influence on neurologic outcome as well.