Complications in carotid endarterectomy are predicted by qualifying symptoms and preoperative CT findings

Objectives: to relate the 30-day perioperative rate of stroke or death in C arotid endarterectomy (CEA) to preoperative qualifying symptoms and to the presence of cerebral infarction (CI) demonstrated on computed tomography (C T). Design: retrospective clinical study. Material and methods: two hundred and seventy-two consecutive CEAs for symp tomatic stenosis in 262 patients were analysed. Results: the total complication rate was 5.9%. Patients with retinal sympto ms (n = 81) had no complications, TIA patients (n=76) had 6.6% (p<0.001). P atients qualifying with minor stroke (n=113) had complications in 9.7% (N.S . compared to TIA patients). Patients qualifying with cortical symptoms had a significantly higher complication rate compared to those with retinal (8 .4% vs. 0%, p=0.004). The presence of a preoperative CT-verified infarction resulted in a higher risk for stroke or death (9.8% vs 2.8%, p=0.008). Wit hin the subgroup presenting with minor stroke, the presence of CI resulted in stroke or death in 13.9%. In patients without CI the corresponding figur e was 2.4% (p=0.017). Conclusion: the qualifying symptoms and the presence of CI visualized by CT influence the complication rate in CEA. When evaluating risk and comparing outcome, these parameters should be included in reporting standards.