[Retrospective evaluation of the carotid endarterectomies performed at CHBAH between 1987 and 2001].
Two broad clinical studies, the ECST and the NASCET, showed that the risk of stroke of carotid origin was significantly reduced by surgery if the stenosis was superior to 70%, if recent symptoms (less than six months) had occurred and if the surgical risk (death or major stroke) was lower than 6%. In the literature the rate of major complications varies from 2.3 to 21%. It is consequently recommended that in each institution or department the results should be evaluated by an independent audit. We studied the 134 carotid thromboendarterectomies carried out in the CHBAH between 1987 and 2001. The surgical indications were generally strictly respected for symptomatic stenoses between 70 and 99%. For asymptomatic stenoses, the indications sometimes retrospectively appear arguable but they remain controversial in the literature also. We regret the absence of preoperative cerebral imaging in one third of the cases. Major complications (death and major stroke) and minor complications (TIA, haematoma, infection, headache, cranial nerve injury,...) were respectively 5.2 and 13.3%, which fits within the recommendations. The Doppler-echo follow-up carried out over the last five years shows a rate of restenosis at 70% of 7.9%, always asymptomatic.
Bilas
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Clinique Joseph Wauters, CHBAH-Site de Waremme, Avenue de la Résistance 2, 4300 Waremme.
Cornette
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D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome