Multicenter retrospective review of results and complications of carotid endarterectomy in 1981

• Published in: Stroke (1970) Vol. 17; no. 3; pp. 370 - 376
• Main Authors: FODE, N. C, SUNDT, T. M. JR, ROBERTSON, J. T, PEERLESS, S. J, SHIELDS, C. B
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.05.1986
• Subjects: Biological and medical sciences; Canada; Carotid Artery Diseases - mortality; Carotid Artery Diseases - physiopathology; Carotid Artery Diseases - surgery; Cerebrovascular Disorders - etiology; Clinical Trials as Topic; Electrocardiography; Endarterectomy - adverse effects; Endarterectomy - classification; Endarterectomy - methods; Female; Hospital Bed Capacity; Humans; Ischemic Attack, Transient - etiology; Male; Medical sciences; Monitoring, Physiologic - classification; Neurology; Retrospective Studies; Specialties, Surgical; United States; Vascular diseases and vascular malformations of the nervous system; Canada; United States; Human; Nervous system diseases; Prognosis; Carotid; Surgery; Multicenter study; Stenosis; Complication; Obliteration; Endarteriectomy; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.str.17.3.370

A multicenter retrospective audit of carotid endarterectomies performed during 1981 was completed with 46 institutions contributing 3,328 cases. Overall, there was a 2.5% risk of transient neurological dysfunction following surgery and a 6% risk of stroke or death. The intra-institutional combined major morbidity and mortality varied from 21% to 0. Those institutions with greater than 700 beds had a statistically lower incidence of stroke or death than did other institutions. The incidence of stroke or death postoperatively was significantly lower for patients who were operated on for amaurosis fugax or for unspecified reasons. Those patients who were operated on for a progressing stroke had a higher incidence of stroke but this group was at greatest risk for stroke without surgery. The incidence of postoperative stroke or death was related to the type of arterial repair; vein patch grafting was statistically better than both fabric patch grafting and primary closure. When all patients who were not monitored during surgery were compared to all patients who had electroencephalographic (EEG) monitoring, there was found to be a significant statistical difference in favor of the EEG group. Endarterectomy combined with coronary artery bypass or simultaneous bilateral endarterectomies had a statistically significant higher incidence of stroke or death than did unilateral carotid endarterectomy.