Carotid endarterectomy in the U.K. and Ireland: audit of 30-day outcome. The Audit Committee for the Vascular Surgical Society.
OBJECTIVE
A prospective study of 709 patients undergoing carotid surgery in the U.K. and Ireland was performed to evaluate the performance of vascular surgeons.


METHODS
Fifty-nine surgeons (range 2-39 cases each) were sampled and all patients undergoing surgery over a 6-month period (1 March 1994-31 August 1994) were included in the study. Indications for surgery were TIA (35.9%), AF (23.3%), CVA (21.4%) and "others" (19.6%).


RESULTS
Mean ipsilateral stenosis was 82% (30%-99%). Thirty-one percent of patients had preoperative neurological consults. Shunts were used in 67.6%, tacking sutures in 40.1%, drains in 71.9% and patches in 54.4% of cases. At 30 days there were nine (1.3%) deaths (four cardiac, three neurological). There were 15 ipsilateral postoperative CVAs (2.1%); 19% of patients had one or more complication, usually minor. Statistical analysis showed no independent risk factor for CVA other than seniority of the surgeon.


CONCLUSIONS
A combined stroke/death rate of 3% for the series was obtained at 30 days for all cases. This large, validated study suggests that members of the Vascular Society of G.B. and Ireland currently have a very low morbidity/mortality rate for performing carotid surgery. Continued audit is required to ensure that this quality of service does not deteriorate.
McCollum
P T
PT
Vascular Unit, Ninewells Hospital, Dundee DD19SY, U.K.
da Silva
A
A
Ridler
B D
BD
de Cossart
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D002561:Cerebrovascular Disorders / Q000150:complications / Q000517:prevention & control / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D002546:Ischemic Attack, Transient / Q000601:surgery; D007902:Length of Stay; D008485:Medical Audit; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012017:Referral and Consultation; D012307:Risk Factors; D006113:United Kingdom