Treatment Strategy and Results of Carotid Endarterectomy in Chronic Renal Failure Patients

• Published in: Nō shinkei geka Vol. 45; no. 2; p. 127
• Main Authors: Murahashi, Takeo, Kamiyama, Kenji, Osato, Toshiaki, Watanabe, Toshiichi, Ogino, Tatsuya, Sugio, Hironori, Endo, Hideki, Takahira, Kazuki, Shindo, Koichiro, Takahashi, Shuhei, Nakamura, Hirohiko
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.02.2017
• Subjects: Aged; Aged, 80 and over; Carotid Stenosis - complications; Carotid Stenosis - diagnosis; Carotid Stenosis - surgery; Endarterectomy, Carotid - adverse effects; Endarterectomy, Carotid - methods; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - surgery; Male; Middle Aged; Risk Assessment; Risk Factors; Stents - adverse effects; Time Factors; Treatment Outcome
• ISSN: 0301-2603
• DOI: 10.11477/mf.1436203462

The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014. Dialysis treatment was initiated due to diabetes in 4 patients and renal sclerosis in 2 patients. All the patients were men, with a mean age of 74.0 years. Two patients were symptomatic, and four were asymptomatic. In all the patients, heart vascular lesions and arteriosclerosis risk factors were present. Postoperatively, pneumonia transient cranial neuropathy, heart failure, and pneumonia in 1 case required extensive treatment. However, by the time of discharge from hospital, no cases had deteriorated compared with their pre-CEA state. The modified Rankin scale score on discharge was 0-2 for all the patients. CEA can be performed safely in patients receiving dialysis, but further operative procedures and careful postoperative management are likely to be needed for patients with CEA who are receiving dialysis.