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Regional Performance of Carotid Endarterectomy, Appropriateness, Outcomes and Risk Factors for Complications
Stroke 28:891-898, 8891997., Wong,J.H.,et al, 1997
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Article Abstract
We found that 41%of patients(118/291)were asymptomatic.Surgical indications were appropriate in 33%of cases(92/281),uncertain in 49%(138/ 281)and inappropriate in 18%(51/281).Stroke or death occurred within 30 days postoperatively in 5.2%(9/174)of symptomatic patients and 5.1%(6/117) of asymptomatic patients.At least one cardiac complications(angina, congestive heart failure,dysrhythmia or myocardial infarction)developed in 8.9%(26/291).Independent preoperative risk factors for stroke or death were histories of angina or congestive heart failure and lack of antiplatelet medication;for cardiac complications,risk factors were age>75 years and a history of congestive heart failure.Almost 1 in 5 patients underwent CEA inappropriately,which was most commonly due to apparent overestimation of stenosis severity,and half had uncertain indications.Our high complication rate possibly negated any overall surgical benefit in the large group of asymptomatic patients.
 
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carotid artery disease
carotid artery disease,asymptomatic
carotid artery stenosis
carotid artery stenosis,measurement of
cerebrovascular accident
cerebrovascular accident,postoperative
endarterectomy,carotid
endarterectomy,carotid-complications of
endarterectomy,carotid-indications for
endarterectomy,carotid-monitoring complications of
mortality
quality control
risk factors

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