Analysis of Bleeding Following Carotid Endarterectomy

Abstract

BACKGROUND: Carotid artery stenosis is one of the main causes of cerebral stroke. Carotid endarterectomy is still the most important technique for treatment. We aimed to reveal the factors which cause major bleeding and need for reoperation in patients treated with carotid endarterectomy and the primary closure technique.

METHODS: Data of 97 patients who received conventional carotid endarterectomy and primary closure at our clinic between 2015 and 2020 were retrospectively analyzed. In line with these data, situations that could lead to major bleeding after surgery such as preoperative blood thinner drug use history, preoperative and postoperative complete blood counts, bleeding times and comorbid diseases were examined.

RESULTS: Four of 97 patients included in the study (4.1%) were reoperated. Among these patients, 2 (50%) were receiving only anticoagulant treatment, while the other 2 (3.1%) were receiving only antiplatelet treatment. The difference between two groups was statistically significant. When the postoperative first day and total drain amounts of the patients in reoperated and nonreoperated group the difference was found significant (P<0.001).

CONCLUSIONS: In our study, while no significant relationship could be found between antiplatelet use in the preoperative period and the prevalence of major bleeding, it was revealed that use of anticoagulant drugs for any reason in the preoperative period may lead to postoperative major bleeding even though the treatment has been stopped before surgery. History of preoperative anticoagulant drug used in patients taken in for reoperation is an issue that needs to be examined and paid attention to.