Carotid Endarterectomy in a Metropolitan Community: Complications in 518 Consecutive Cases

Abstract

The records of 518 consecutive carotid endarterectomies done in 427 patients in one institution were evaluated for perioperative complications and catego rized according to their presenting syndrome. Of this surgery, 62.9% was done for hemispheric transient ischemic attack (TIA), 14.5% for nonhemispheric TIAs, 7.9% in patients with previous stroke, and 14.7% for asymptomatic sig nificant carotid stenosis. Each group's complication rate was then evaluated and compared with rates in comparable studies. The postoperative stroke rate and the combined stroke and death rate were 2.6% and 2.6%, respectively, for the group with asymptomatic significant carotid stenosis; 2.7% and 4%, respec tively, for the group with nonhemispheric TIA; 4% and 4.6%, respectively, for the group with hemispheric TIA; and 7.3% and 7.3%, respectively, in the group with previous stroke. The combined postoperative stroke rate for the whole series was 3.9% and the death rate was 1.4% with a combined stroke and death rate of 4.4%. This study points out the need to categorize patients who have had carotid endarterectomy by their presenting syndrome before comparing them with pa tients in other studies.