What is the prevalence of cranial nerve injuries following carotid endarterectomy (CEA)?

Updated: Oct 24, 2019
  • Author: Sonia Nhieu, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Although CN injuries are rarely considered in discussions of postoperative complications after a CEA, they are potentially serious when they do occur and can be life-threatening if they occur bilaterally. The reported incidence of CN injuries ranges from 2% to greater than 50%, with most such injuries being transient and secondary to neurapraxia caused by excessive retraction. [19]

Because the clinical implications of a CN injury are similar to those of a minor stroke, proponents of carotid artery stenting claim that these injuries should be included in the composite endpoint of trials comparing stenting with CEA. [19]  However, the incidence of a permanent or disabling CN injury is very low, and for this reason, opponents of carotid artery stenting argue that this low injury risk should not detract from the significant benefit of stroke prevention conferred by CEA. [20]

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