Surgical outcome of carotid artery disease: Analysis of 367 carotid endarterectomies

Carotid endarterectomy is a method of prophylaxis. A total of 367 carotid e ndarterectomies in 335 patients were performed during the period of 1989-19 97: 222 (66.3%) were symptomatic and 113 (33.7%) asymptomatic patients. In all, 262 (78.2%) had unilateral, 41 (12.2%) contralateral occlusion and 32 (9.6%) bilateral artery disease, All were operated on under general anesthe sia without using shunt or patch. Of the patients with bilateral occlusive disease, 17 underwent simultaneous and 15 staged endarterectomy; The mortal ity rate of the first 30 postoperative days was 1.19% and the mortality/str oke rate 2.38%. Transient neurogenic dysfunction occurred in 3.68%, myocard ial ischemia in 0.89%, and postoperative hypertension in 16.7%. Endarterectomy of symptomatic and asymptomatic patients with unilateral loc alisation, contralateral occlusion or bilateral occlusive disease remains a highly acceptable prophylactic method. The future will show whether other endovascular procedures affect the broad application of carotid endarterect omy.