Long-term functional consequences of cranial nerve injuries after carotid endarterectomy

J Cardiovasc Surg (Torino). 2022 Dec;63(6):695-699. doi: 10.23736/S0021-9509.22.12321-9. Epub 2022 Sep 28.


Background: The aim of the study was to investigate long-term patient consequences of cranial nerve injury (CNI) caused by carotid endarterectomy (CEA) in patients with identified CNI at the 30-day follow-up.

Methods: Consecutive patients operated for symptomatic carotid artery stenosis 2015-2019 with a documented CNI at the 30-day follow-up after CEA were recruited to this cross-sectional survey. Telephone interviews were conducted >1 year after CEA utilizing survey instruments developed to uncover CNI symptoms. Patients graded their symptoms on a 4-point scale: 1) no symptoms; 2) mild symptoms; 3) moderate symptoms; and 4) severe symptoms.

Results: Altogether, 477 patients underwent CEA, of which 82 were diagnosed with CNI; 70/82 patients remained alive at the time for the survey and 68 patients completed the interview. The mean follow-up time was 3.7 years. Severe persistent CNI symptoms were reported in 2/68 (2.9%), moderate symptoms in 1/68 (1.5%) and mild symptoms in 14/68 (21%) whereas 51/68 patients (75%) reported no residual symptoms. When extrapolating these findings to all patients, approximately 4.4% reported persistent symptoms at the long-term follow-up and only 0.8% reported moderate or severe symptoms.

Conclusions: The long-term consequences of CNI following CEA are benign in most patients, with a high rate of symptom resolution and a very low rate of persistent clinically significant symptoms.

MeSH terms

  • Carotid Stenosis* / complications
  • Carotid Stenosis* / diagnostic imaging
  • Carotid Stenosis* / surgery
  • Cranial Nerve Injuries* / diagnosis
  • Cranial Nerve Injuries* / etiology
  • Cross-Sectional Studies
  • Endarterectomy, Carotid* / adverse effects
  • Humans
  • Retrospective Studies
  • Risk Factors
  • Stroke* / etiology
  • Treatment Outcome