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Of the 697 patients with ipsilateral symptoms,8.5%had either stroke, myocardial infarction,or died during the postoperative period of hospitalization.Those over the age of 75 had a greater risk of myocardial infarction(6.6%versus 2.3%,P=.024)but not of stroke or death(P>.10).The overall frequencies of adverse outcomes were also higher in the 5 patients with complete ipsilateral carotid occlusions(40%versus 8.2%,P<.01),the 28 patients with ipsilateral intraluminal thrombus(17.9%versus 8.1%,P-.07), and the 65 patients with ipsilateral carotid siphon stenosis(13.9%versus 7.9%,P=.10)."High-risk"patients(one or more risk factors)had more than two times the risk of complications compared with"low-risk"patients who had no risk factors(odds ratio,2.18,95%confidence interval,1.25 to 3.81).Certain preoperative clinical variables may place patients with ipsilateral symptoms at greater risk of perioperative complications after carotid endarterectomy.Prospective validation of a simple risk index would provide an additional method for assessing preoperative risk in endarterectomy candidates. |
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