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Spontaneous Echo Contrast and Thrombus Formation at the Carotid Bifurcation After Carotid Endarterectomy

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Title: Spontaneous Echo Contrast and Thrombus Formation at the Carotid Bifurcation After Carotid Endarterectomy
Authors: Kawabori, Masahito Browse this author →KAKEN DB
Yoshimoto, Tetsuyuki Browse this author
Ito, Masaki Browse this author
Fujimoto, Shin Browse this author
Mikami, Taisei Browse this author →KAKEN DB
Muraki, Mutsuko Browse this author
Kaneko, Sadao Browse this author
Nakayama, Naoki Browse this author →KAKEN DB
Kuroda, Satoshi Browse this author →KAKEN DB
Houkin, Kiyohiro Browse this author →KAKEN DB
Keywords: carotid endarterectomy
spontaneous echo contrast
anticoagulant therapy
Issue Date: Dec-2012
Publisher: The Japan Neurosurgical Society
Journal Title: Neurologia medico-chirurgica
Volume: 52
Issue: 12
Start Page: 885
End Page: 891
Publisher DOI: 10.2176/nmc.52.885
Abstract: Spontaneous echo contrast (SEC) consists of numerous microechoes swirling in the cardiovascular lumen and is usually seen during blood stasis in dysfunctional left atrium. However, SEC and consecutive local thrombus formation at the carotid artery early after carotid endarterectomy (CEA) have not been reported. This study retrospectively investigated the clinical importance and therapeutic strategy of postoperative SEC and thrombus formation in 113 consecutive patients who underwent CEA between 2001 and 2009. Ultrasonography was routinely performed preoperatively, intraoperatively, and 1 day and 1 week after the operation. If SEC and/or thrombus was detected at any time after the operation, follow-up ultrasonography was performed at short intervals, once a week for inpatients and once every 1-2 months for outpatients. Eight of the 113 patients (7%) had SEC after the operation from Day 1 to 12 (mean 7.2 days), and 6 of these 8 patients developed local de novo thrombus formation at the site of SEC from Day 6 to 33 (mean 14.7 days). The maximum luminal narrowing by the thrombi were 26-62% (mean 37%). After administering anticoagulant therapy, all thrombi disappeared from Day 13 to 190 (mean 57 days) from CEA. SEC seen after CEA is highly associated with consecutive local thrombus formation. Postoperative geometric blood stasis with the absence of intima may be the causative factor for its development.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 川堀 真人

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