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Indications for Angiography and Carotid Endarterectomy

William C. Tompkins, MD; Ronald L. Vander Molen, MD; Hagop D. Yacoubian, MD; John E. Connolly, MD

Arch Surg. 1975;110(9):1075-1078.

Abstract
Six patients with ocular symptoms were referred by the Eye Service to the Vascular Service because of the presence of cholesterol emboli on fundoscopic examination of the retinal arteries. None of the six patients had classic intermittent retinal or cerebral ischemic attacks. Four-vessel aortic arch arteriogram was suggested and significant ipsilateral carotid disease was found in all patients. Four patients underwent carotid endarterectomy, with removal of ulcerated plaques from the carotid bifurcation. Two patients had total occlusion of the ipsilateral internal carotid artery and therefore were not operative candidates. The presence of retinal cholesterol emboli is an indication for extracranial arteriography. When ipsilateral ulcerative disease is found, carotid endarterectomy is indicated regardless of the symptoms.

Author Affiliations
From the Department of Surgery, University of California, Irvine, and the Veterans Administration Hospital, Long Beach, Calif.

Footnotes
Accepted for publication Feb 11, 1975.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara, Calif, Jan 17, 1975.

Reprint requests to Department of Surgery, University of California, Irvine, CA 92664 (Dr. Connolly).

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ABSTRACT