CAROTID ENDARTERECTOMY - RESULTS IN ASYMPTOMATIC AND SYMPTOMATIC PATIENTS

Objective evidence of the benefit of carotid endarterectomy in prevent ing stroke and its significant sequelae has recently been demonstrated by prospective trials. The salutary results depend on meeting strict operative outcome criteria as established by the American Heart Associ ation. We retrospectively analyzed 265 consecutive carotid endarterect omies performed in 248 patients during 1 year at our institution. The perioperative mortality rate was 0; late mortality occurred 6 months p ostoperatively in 1 of 2 patients who experienced a perioperative stro ke. The combined perioperative mortality and stroke rate was 0.8%. The combined mortality and stroke rate in patient subgroups was 0.7% (1/1 51) for asymptomatic patients, 1.6% (1/64) for symptomatic patients wh o had presented with a transient ischemic attack and 0% (0/50) for sym ptomatic patients who had presented with a completed stroke. We conclu de that the objective postoperative benefits of carotid endarterectomy in treating extracranial cerebrovascular disease can be achieved with low perioperative patient morbidity.