Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2018 , Vol 27 , Issue 2
Medical treatment experience following carotid endarterectomy in atrial fibrillation presenting with carotid artery stenosis
İbrahim Erdinç1, Didem Melis Öztaş2, İbrahim Demir2, Murat Uğurlucan2, Hakkı Tankut Akay3
1İzmir Bozyaka Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İzmir, Türkiye
2İstanbul Üniversitesi İstanbul Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye
3Başkent Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye
DOI : 10.9739/tjvs.2018.125 Objectives: In this study, we aimed to present our anticoagulant treatment strategies and experiences in patients with atrial fibrillation undergoing carotid endarterectomy.

Patients and methods: Between January 2001 and April 2015, a total of 817 patients were operated due to carotid artery stenosis in our clinic. A total of 102 patients (62 females, 40 males; mean age 67.2±9.4 years; range, 41 to 87 years) with the diagnosis of atrial fibrillation were retrospectively analyzed. All patients were on warfarin and aspirin treatment.

Results: One patient died in the early postoperative period due to sudden hypotension after dialysis, followed by cardiac arrest. Twelve patients died due to various reasons in the late postoperative period. Seven patients required re-exploration due to hematoma. Three patients had a neurological event characterized by hemiparesis in the early postoperative period and all of them were regressed with heparin and anti-edema therapy. Four patients had re-stenosis. Percutaneous stent graft implantation was performed in three patients. One patient was re-operated.

Conclusion: Aspirin 100 mg daily combined with warfarin keeping the international normalized ratio of 2 to 3 was an appropriate treatment option for our patient group. However, further, multi-center, large-scale studies are required to establish a definite anticoagulant treatment protocol for patients with atrial fibrillation undergoing carotid endarterectomy. Keywords : Anticoagulant therapy; atrial fibrillation; carotid artery disease; carotid endarterectomy

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