{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:18:04Z","timestamp":1751516284829,"version":"3.41.0"},"reference-count":10,"publisher":"International College of Surgeons","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>The purpose of this study is to assess the 30-day postoperative incidence of death, myocardial infarction, stroke, wound complication, and cranial nerve damage after carotid endarterectomy using induced hypertension (systolic pressure \u2265160\u00a0mmHg), selective shunting, and primary closure. We retrospectively analyzed the records of 206 patients who underwent a total of 239 carotid endarterectomy surgeries between January 2002 and August 2009 to identify the impact of selective shunting and primary closure on morbidity and mortality. Two hundred thirty-nine surgeries were performed on 206 patients. The study population was 55% men and 45% women with average age of 67\u00a0years (range 33\u201385\u00a0years). Of these patients, 181 had hypertension (88%), 82 had diabetes (40%), 73 had peripheral vascular disease (35%), 107 had coronary artery disease (52%), 142 had tobacco abuse (69%), and 146 had dyslipidemia (71%). Twenty-six patients (13%) presented with history of stroke, 77 (37%) with transient ischemic attack (TIA), 14 (7%) with amaurosis fugax, and 108 (52%) were asymptomatic. The average internal carotid stenosis was 74% as indicated by duplex, computed tomography, magnetic resonance imaging, or angiogram. Of the 239 surgeries, 3 (1%) required patch closure, and 7 (3%) required shunt. Thirty-day postoperative complication rates are as follows: stroke, 3 (1.3%); TIA, 4 (1.7%); bleeding, 5 (2.1%); superficial wound infection, 2 (0.8%); heart attack, 1 (0.4%); cranial nerve injury, 0; and hospital death, 0. One patient (0.4%) died at home from an unknown cause. In conclusion, carotid endarterectomy with selective shunting and primary closure is a safe and effective surgical means of preventing stroke.<\/jats:p>","DOI":"10.9738\/1338.1","type":"journal-article","created":{"date-parts":[[2012,12,13]],"date-time":"2012-12-13T18:34:45Z","timestamp":1355423685000},"page":"60-63","source":"Crossref","is-referenced-by-count":2,"title":["Carotid Endarterectomy: Outcome of \u201cOld-Fashioned\u201d Approach"],"prefix":"10.9738","volume":"96","author":[{"given":"Jeff","family":"Oldham","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sibu","family":"Saha","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"6","key":"i0020-8868-96-1-60-Thom1","series-title":"Circulation","first-page":"e85","article-title":"Heart disease and stroke statistics\u20142006 update: a report from the American Heart Association Statistics Committee and Stoke Statistics subcommittee.","volume":"113","author":"Thom, T","year":"2006","unstructured":"Thom, T, HaaseN, RosamondW, HowardVJ, RumsfeldJ, ManolioT, et al. Heart disease and stroke statistics\u20142006 update: a report from the American Heart Association Statistics Committee and Stoke Statistics subcommittee.Circulation2006. 113 (6):e85\u2013e151."},{"issue":"11","key":"i0020-8868-96-1-60-Robertson1","series-title":"Stroke","first-page":"2435","article-title":"Carotid endarterectomy: a saga of clinical science, personalities, and evolving technology.","volume":"29","author":"Robertson, J","year":"1998","unstructured":"Robertson, J\n          . Carotid endarterectomy: a saga of clinical science, personalities, and evolving technology.Stroke1998. 29 (11):2435\u20132441."},{"issue":"3","key":"i0020-8868-96-1-60-Cooley1","series-title":"Texas Heart Instit J","first-page":"139","article-title":"Carotid endarterectomy: from first recorded case to present.","volume":"15","author":"Cooley, DA","year":"1988","unstructured":"Cooley, DA\n          . Carotid endarterectomy: from first recorded case to present.Texas Heart Instit J1988. 15 (3):139\u2013141."},{"issue":"6","key":"i0020-8868-96-1-60-North1","series-title":"Stroke","first-page":"711","article-title":"North American Symptomatic Carotid Endarterectomy Trial. Methods, patient characteristics, and progress.","volume":"22","year":"1991","unstructured":"North American Symptomatic Carotid Endarterectomy Trial (NASCET) Steering Committee\n          \n          North American Symptomatic Carotid Endarterectomy Trial. Methods, patient characteristics, and progress.\n          Stroke\n          1991. 22 (6):711\u2013720."},{"issue":"7","key":"i0020-8868-96-1-60-North2","series-title":"N Engl J Med","first-page":"445","article-title":"Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis.","volume":"325","year":"1991","unstructured":"North American Symptomatic Carotid Endarterectomy Trial Collaborators\n          \n          Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis.\n          N Engl J Med\n          1991. 325 (7):445\u2013453."},{"issue":"9113","key":"i0020-8868-96-1-60-MRC1","series-title":"Lancet","first-page":"1379","article-title":"Randomized trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST).","volume":"351","year":"1998","unstructured":"MRC European Carotid Surgery Trial\n          \n          Randomized trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST).\n          Lancet\n          1998. 351 (9113):1379\u20131387."},{"issue":"4","key":"i0020-8868-96-1-60-Hobson1","series-title":"N Engl J Med","first-page":"221","article-title":"Efficacy of carotid endarterectomy for asymptomatic carotid stenosis. The Veterans Affairs Cooperative Study Group.","volume":"328","author":"Hobson\n              2nd, RW","year":"1993","unstructured":"Hobson\n              2nd, RW, WeissDG, FieldsWS, GoldstoneJ, MooreWS, TowneJB, et al. Efficacy of carotid endarterectomy for asymptomatic carotid stenosis. The Veterans Affairs Cooperative Study Group.N Engl J Med1993. 328 (4):221\u2013227."},{"issue":"18","key":"i0020-8868-96-1-60-Executive1","series-title":"JAMA","first-page":"1421","article-title":"Endarterectomy for asymptomatic carotid artery stenosis.","volume":"273","year":"1995","unstructured":"Executive Committee for the Asymptomatic Carotid Atherosclerosis Study\n          \n          Endarterectomy for asymptomatic carotid artery stenosis.\n          JAMA\n          1995. 273 (18):1421\u20131428."},{"issue":"6","key":"i0020-8868-96-1-60-Woodworth1","series-title":"Neurosurgery","first-page":"1170","article-title":"Selective versus routine intraoperative shunting during carotid endarterectomy: a multivariate outcome analysis.","volume":"61","author":"Woodworth, GF","year":"2007","unstructured":"Woodworth, GF, McGirtMJ, ThanKD, HuangJ, PerlerBA, and TamargoRJ. Selective versus routine intraoperative shunting during carotid endarterectomy: a multivariate outcome analysis.Neurosurgery2007. 61 (6):1170\u20131177."},{"key":"i0020-8868-96-1-60-Bond1","series-title":"Cochrane Database Sys Rev","first-page":"CD000160","article-title":"Patch angioplasty versus primary closure for carotid endarterectomy.","volume":"2","author":"Bond, R","year":"2004","unstructured":"Bond, R, RerkasemK, AbuRahmaAF, NaylorAR, and RothwellPM. Patch angioplasty versus primary closure for carotid endarterectomy.Cochrane Database Sys Rev2004. 2:CD000160."}],"container-title":["International Surgery"],"original-title":[],"link":[{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/96\/1\/article-p60.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/international-surgery\/article-pdf\/96\/1\/60\/2213889\/1338_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/96\/1\/article-p60.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/96\/1\/article-p60.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T19:06:17Z","timestamp":1751483177000},"score":1,"resource":{"primary":{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/96\/1\/article-p60.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,1]]},"references-count":10,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.9738\/1338.1","relation":{},"ISSN":["0020-8868","2520-2456"],"issn-type":[{"type":"print","value":"0020-8868"},{"type":"electronic","value":"2520-2456"}],"subject":[],"published":{"date-parts":[[2011,1]]}}}