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Stroke, Vol 17, 370-376, Copyright © 1986 by American Heart Association
NC Fode, TM Sundt Jr, JT Robertson, SJ Peerless and CB Shields
A multicenter retrospective audit of carotid endarterectomies performed
during 1981 was completed with 46 institutions contributing 3,328 cases.
Overall, there was a 2.5% risk of transient neurological dysfunction
following surgery and a 6% risk of stroke or death. The intra-institutional
combined major morbidity and mortality varied from 21% to 0. Those
institutions with greater than 700 beds had a statistically lower incidence
of stroke or death than did other institutions. The incidence of stroke or
death postoperatively was significantly lower for patients who were
operated on for amaurosis fugax or for unspecified reasons. Those patients
who were operated on for a progressing stroke had a higher incidence of
stroke but this group was at greatest risk for stroke without surgery. The
incidence of postoperative stroke or death was related to the type of
arterial repair; vein patch grafting was statistically better than both
fabric patch grafting and primary closure. When all patients who were not
monitored during surgery were compared to all patients who had
electroencephalographic (EEG) monitoring, there was found to be a
significant statistical difference in favor of the EEG group.
Endarterectomy combined with coronary artery bypass or simultaneous
bilateral endarterectomies had a statistically significant higher incidence
of stroke or death than did unilateral carotid endarterectomy.
ARTICLES
Multicenter retrospective review of results and complications of carotid endarterectomy in 1981
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