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December 1982

Carotid Artery SpasmA Cause of Postendarterectomy Thrombosis?

Author Affiliations

From the Departments of Surgery (Drs Lye and Downs) and Radiology (Dr Morrow), University of Manitoba, Winnipeg.

Arch Surg. 1982;117(12):1531-1536. doi:10.1001/archsurg.1982.01380360007003

• Carotid endarterectomy is generally regarded as a durable repair, with a low incidence of postoperative thrombosis. However, unexpected, inexplicable occlusions and pressure-flow aberrations have been reported to occur during the period Immediately after operation period. We studied 245 operative angiograms obtained during a series of 335 carotid endarterectomies. Among the various defects noted were 24 instances of mild to severe spasm of the middle and distal extracranial carotid artery. This spasm was remote from the endarterectomy site and often was entirely beyond the field of operative exposure. Early and late postoperative angiograms demonstrated that this may be a transient phenomenon, and repeated intraoperative films documented that spasm may progress without further direct instrumentation of the involved segment. The patient who demonstrated the most severe spasm later suffered immediate postoperative occlusion and stroke despite a technically satisfactory repair.

(Arch Surg 1982;117:1531-1536)

Turnipseed WD, Berkoff HA, Crummy A:  Postoperative occlusion after carotid endarterectomy. Arch Surg 1980;115:573-574.Article
Cantelmo NL, Cutler BS, Wheeler HB, et al:  Noninvasive detection of carotid stenosis following endarterectomy. Arch Surg 1981;116:1005-1008.Article
Ortego G, Gee W, Kaupp HA, et al:  Postendarterectomy carotid occlusion. Surgery 1981;90:1093-1098.
Kwaan JHM, Connelly JE, Sharefkin JB:  Successful management of early stroke after carotid endarterectomy. Ann Surg 1979;190:676-678.Article
French BN, Newcastle NB:  Sequential morphological changes at the site of carotid endarterectomy. J Neurosurg 1974;41:745-754.Article
Blaisdell FW, Lim R, Hall AD:  Technical result of carotid endarterectomy: Arteriographic assessment. Am J Surg 1967;114:239-246.Article
Treiman RL, Cossman EV, Cohen JL, et al:  Management of postoperative stroke after carotid endarterectomy. Am J Surg 1981;142:236-238.Article
Whitney DG, Kahn EM, Estes JW, et al:  Carotid artery surgery without a temporary indwelling shunt. Arch Surg 1980;115:1393-1399.Article
Andersen CA, Collins GJ, Rich NM:  Routine operative angiography during carotid endarterectomy: A reassessment. Surgery 1978;83:67-73.
Lindbom A:  Arterial spasm caused by puncture and catheterization. Acta Radiol 1957;47:449-460.Article
Gurdjian ES, Audet B, Sibayan R, et al:  Spasm of the extracranial internal carotid artery resulting from blunt trauma demonstrated by angiography. J Neurosurg 1971;35:742-747.Article
Hunter J: Works , Palmer JF (ed.). London, Longman & Co, 1835, vol 1, p 538.
Cohen SM:  Traumatic arterial spasm. Lancet 1944;1:1-6.Article
Schutz H, Fleming JFR, Awerbuck B:  Arteriographic assessment of carotid endarterectomy. Ann Surg 1970;171:509-521.Article