ArticleEuropean journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery2014
Clinical relevance of cranial nerve injury following carotid endarterectomy.
Article in European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 74 citations in OpenAlex.
- Incidence, outcomes, and effect on quality of life of cranial nerve injury in the Carotid Revascularization Endarterectomy versus Stenting Trial.Journal of vascular surgery · 2015Trial
- Mapping the Common Carotid Artery Bifurcation Utilizing Anterior Neck Landmarks.Diagnostics (Basel, Switzerland) · 2026Article
- Anatomical features and clinical significance of the ascending pharyngeal artery in carotid endarterectomy.Neurosurgical review · 2025Article
- Transcarotid artery revascularization for carotid pseudoaneurysm and patch degeneration after carotid endarterectomy.Journal of vascular surgery cases and innovative techniques · 2023Article
- Study on the Influencing Factors of Short-Term Recovery of Neurological Symptoms after Carotid Body Tumor Resection.World journal of surgery · 2023Article
- High Mini-Skin Incision during Carotid Endarterectomy for Carotid Stenosis.Journal of chest surgery · 2022Article
- Complex redo cervical and vertebral artery reconstruction for Takayasu arteritis.Journal of vascular surgery cases and innovative techniques · 2021Article
- Perioperative Stroke.Current neurology and neuroscience reports · 2020Review
- Outcomes after Transverse-Incision 'Mini' Carotid Endarterectomy and Patch-Plasty.Vascular specialist international · 2019Article
- Usefulness of preoperative three-dimensional volumetric analysis of carotid body tumors.Neuroradiology · 2018Article
- Cervical plexus block.Korean journal of anesthesiology · 2018Article
- Article
- Review
- The impact of contralateral carotid artery stenosis on outcomes after carotid endarterectomy.Journal of vascular surgery · 2017Article
- Surgical and Endovascular Treatment of Extracranial Carotid Stenosis.Deutsches Arzteblatt international · 2017Article
- Atypical location of the hypoglossal nerve and its implications: a case report.Surgical and radiologic anatomy : SRA · 2016Article
- Right carotid-cutaneous fistula and right carotid pseudoaneurysm formation secondary to a chronically infected polyethylene terephthalate patch.International journal of critical illness and injury scienceArticle
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesThe benefit of carotid endarterectomy (CEA) may be diminished by cranial nerve injury (CNI). Using a quality improvement registry, we aimed to identify the nerves affected, duration of symptoms (transient vs. persistent), and clinical predictors of CNI.
methodsWe identified all patients undergoing CEA in the Vascular Study Group of New England (VSGNE) between 2003 and 2011. Surgeon-observed CNI rate was determined at discharge (postoperative CNI) and at follow-up to determine persistent CNI (CNIs that persisted at routine follow-up visit). Hierarchical multivariable model controlling for surgeon and hospital was used to assess independent predictors for postoperative CNI.
resultsA total of 6,878 patients (33.8% symptomatic) were included for analyses. CNI rate at discharge was 5.6% (n = 382). Sixty patients (0.7%) had more than one nerve affected. The hypoglossal nerve was most frequently involved (n = 185, 2.7%), followed by the facial (n = 128, 1.9%), the vagus (n = 49, 0.7%), and the glossopharyngeal (n = 33, 0.5%) nerve. The vast majority of these CNIs were transient; only 47 patients (0.7%) had a persistent CNI at their follow-up visit (median 10.0 months, range 0.3-15.6 months). Patients with perioperative stroke (0.9%, n = 64) had significantly higher risk of CNI (n = 15, CNI risk 23.4%, p < .01). Predictors for CNI were urgent procedures (OR 1.6, 95% CI 1.2-2.1, p < .01), immediate re-exploration after closure under the same anesthetic (OR 2.0, 95% CI 1.3-3.0, p < .01), and return to the operating room for a neurologic event or bleeding (OR 2.3, 95% CI 1.4-3.8, p < .01), but not redo CEA (OR 1.0, 95% CI 0.5-1.9, p = .90) or prior cervical radiation (OR 0.9, 95% CI 0.3-2.5, p = .80).
conclusionsAs patients are currently selected in the VSGNE, persistent CNI after CEA is rare. While conditions of urgency and (sub)acute reintervention carried increased risk for postoperative CNI, a history of prior ipsilateral CEA or cervical radiation was not associated with increased CNI rate.
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