Carotid endarterectomy. Clinical results in a community-based teaching hospital.
Since 1971, 688 consecutive carotid endarterectomies were performed in 612 patients in a community-based teaching hospital by 16 surgeons; 82% of the procedures were performed in patients who had suffered a transient ischemic attack, amaurosis fugax, or a previous stroke. Seven patients (1%) died, five of perioperative stroke and two of myocardial infarction. Thirty-one patients suffered a perioperative stroke (4.5% of the 688 endarterectomies); 20 patients (2.9% of 688) were left with moderate to severe neurologic deficits. The combined mortality/major neurologic deficit morbidity rate (number of patients divided by number of endarterectomies) is 3.2%. Both operative mortality and morbidity have progressively declined in successive 5-year periods, with no deaths and a 2.7% stroke rate in 148 endarterectomies performed after 1984. Our results indicate that carotid endarterectomy as practiced in a community-based teaching hospital can be performed without excessive risk.
Friedmann
P
P
Department of Surgery, Baystate Medical Center, Springfield University School of Medicine, Boston, Massachusetts 01199.
Garb
J L
JL
Berman
J
J
Sullivan
C
C
Celoria
G
G
Rhee
S W
SW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology; D002339:Carotid Arteries / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000209:etiology; D004691:Endarterectomy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology