CAROTID ENDARTERECTOMY IN DURBAN - THE 1ST 10 YEARS

This study was a prospective evaluation of the Durban experience with carotid endarterectomy over the past decade. Since 1981, 478 carotid e ndarterectomies have been performed in 411 patients. The majority of t hese patients were white men, with an average age of 60,6 years. The i ndication for surgery was a lateralising transient ischaemic attack or amaurosis fugax in 65,5%, lateralising stroke (< 1 year before surger y) in 14,4%, non-lateralising global cerebral ischaemia in 9,4% and as ymptomatic carotid stenosis in 10,7%. Carotid endarterectomy was perfo rmed under general anaesthesia and with invasive monitoring; 25% of pa tients underwent selective shunting. After open carotid bifurcation en darterectomy, all but 6 underwent primary closure (99,4%). The combine d major stroke/mortality rate was 6%. This audit identified a group of patients who presented with a history of stroke within the year prece ding surgery and who had a significantly higher postoperative stroke/m ortality rate of 20,2%. Long-term follow-up, ranging from 1 month to 9 6 months, showed 80,7% to be stroke-free after 8 years. This audit dem onstrates a postoperative stroke/mortality rate comparable to that of other series and additionally confirmed the durability of carotid enda rterectomy in the long term.