CAROTID ENDARTERECTOMY IN GREAT-BRITAIN AND IRELAND - PRACTICE BETWEEN 1984 AND 1992

Of 356 questionnaires on carotid endarterectomy sent to all vascular s urgeons in Great Britain and Ireland likely to undertake this procedur e, 326 (92 per cent) were returned. Of those who replied 131 (40 per c ent) performed at least one carotid endarterectomy in 1992; 57 (44 per cent) of these carried out ten or fewer operations and 74 (56 per cen t) more than ten. The 131 surgeons were collectively responsible for 2 628 operations in 1992, twice as many as were undertaken in either 198 4 or 1989, years for which similar survey data are available. This sha rp rise in the number of operations was accounted for by increased act ivity on the part of experienced operators, rather than any rise in th e number of 'occasional' carotid surgeons. In 1992, although the neuro logist remained a major source of patient referral, general practition ers (and others) were also referring patients in large numbers direct to the vascular surgeon; this represents a change in practice compared with previous years. Many of the technical aspects surrounding caroti d endarterectomy remained unchanged over the years surveyed (1984, 198 9, 1992) but by 1992 duplex scanning, intra-arterial (but not intraven ous) digital subtraction angiography and transcranial Doppler ultrason ography had become established as clinically useful techniques.