Complications in carotid endarterectomy are predicted by qualifying symptoms and preoperative CT findings.
OBJECTIVE
To relate the 30-day perioperative rate of stroke or death in carotid endarterectomy (CEA) to preoperative qualifying symptoms and to the presence of cerebral infarction (CI) demonstrated on computed tomography (CT).


METHODS
Retrospective clinical study.


METHODS
Two hundred and seventy-two consecutive CEAs for symptomatic stenosis in 262 patients were analysed.


RESULTS
The total complication rate was 5.9%. Patients with retinal symptoms (n = 81) had no complications, TIA patients (n = 76) had 6.6% (p < 0.001). Patients qualifying with minor stroke (n = 113) had complications in 9.7% (N.S. compared to TIA patients). Patients qualifying with cortical symptoms had a significantly higher complication rate compared to those with retinal (8.4% vs. 0%, p = 0.004). The presence of a preoperative CT-verified infarction resulted in a higher risk for stroke or death (9.8% vs 2.8%, p = 0.008). Within the subgroup presenting with minor stroke, the presence of CI resulted in stroke or death in 13.9%. In patients without CI the corresponding figure was 2.4% (p = 0.017).


CONCLUSIONS
The qualifying symptoms and the presence of CI visualized by CT influence the complication rate in CEA. When evaluating risk and comparing outcome, these parameters should be included in reporting standards.
Blohmé
L
L
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Sandström
V
V
Hellström
G
G
Swedenborg
J
J
Takolander
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D002544:Cerebral Infarction / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data