[Encouraging late results after surgery of supra-aortic vascular stenoses].
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Biomedical subjects
Publications and source records attributed to T Grobe.
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Since 1965 we have performed 602 reconstructions at the supraaortic branches, mainly at the carotid artery. Follow-up showed equally good long-term results in subclavian reconstructions by transthoracic and extrathoracic approach. The patency was 90% after 6 years. Mortality in carotid endarterectomy was 1.6%. According to the Life Table Method the survival rate was 57.6% after 5 years in stage I, 73.7% in stage II, and 66% in stage IV.
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Since 1962 until 1976 we have performed 335 operations on the carotid artery in 268 patients. In 1977 we were able to obtain information from 265 patients. The early mortality in stage I, II and IV was one to three percent, in stage III 40 percent. The cumulative survival rate after four years was 74 percent. The main causes of death were cardiac diseases. Often the patients also had heart failure, peripheral arterial diseases, hypertension, and diabetes. Following the operation at least one third of the patients had an improvement of their symptoms.
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Peripheral nerve injuries may complicate extracranial vascular surgery. Pareses of the recurrent and hypoglossal nerves are clinically important. The nervus laryngeus superior, the ramus marginalis mandibulae of the facial nerve and the brachial plexus may be involved. Horner's syndrom indicating damage of sympathetic fibers may also appear. Lesions of the glossopharyngeal, vagus and phrenic nerves are rather seldom.
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