Regional Performance of Carotid Endarterectomy

• DOI: 10.1161/01.str.28.5.891
• Publication Date: 2011-06-17T20:08:03Z
• Authors: John H. Wong; J. Max Findlay; Maria E. Suarez-A...
• Keywords: Stroke; Unstable angina; Endarterectomy

Guided by the findings of randomized controlled trials evaluating carotid endarterectomy (CEA), we examined appropriateness CEAs performed in our city and determined incidences risk factors for postoperative stroke, death, cardiac complications.Using health records, retrospectively reviewed 291 consecutive region over 18 months. Based on trial results standardized remeasurements angiographic stenoses, indications CEA were considered appropriate symptomatic stenoses > or = 70%, uncertain < 70% 60% asymptomatic inappropriate patients with preoperative neurological medical instability.We found that 41% (118/291) asymptomatic. Surgical 33% cases (92/281), 49% (138/281), 18% (51/281). Stroke death occurred within 30 days postoperatively 5.2% (9/174) 5.1% (6/117) patients. At least one complication (angina, congestive heart failure, dysrhythmia, myocardial infarction) developed 8.9% (26/291). Independent stroke histories angina failure lack antiplatelet medication; complications, age 75 years a history failure.Almost 1 5 underwent inappropriately, which was most commonly due to apparent over-estimation stenosis severity, half had indications. Our high rate possibly negated any overall surgical benefit large group