INFLUENCE OF SURGICAL EXPERIENCE ON THE RESULTS OF CAROTID SURGERY

Objective: To assess the 30-day mortality and morbidity rates related to carotid endarterectomy on a nation-wide basis. Design: Retrospectiv e cross-sectional study based on vascular registry Finnvasc. Materials and methods: A total of 17 465 recorded vascular and endovascular pro cedures included exactly 1600 carotid endarterectomies performed by 10 4 surgeons in 23 hospitals. Fourteen per cent of the patients were ope rated on for asymptomatic carotid stenosis. Results: The combined mort ality and permanent stroke rate was 3.3%, without any difference betwe en operations done on symptomatic or asymptomatic patients. There was a clear inverse association between surgeon's carotid case load and po or outcomes in carotid surgery (p<0.005), the critical patient mass pe r surgeon and year being 10 operations. There was no association betwe en outcome after carotid surgery and hospital volume of carotid operat ions. Conclusions: Surgeon's experience in carotid surgery clearly imp roves the results of carotid surgery.