Clinical review of 106 consecutive carotid endarterectomies

We have reviewed 106 consecutive carotid endarterectomies performed from 1966 through 1973. During this period, 99 elective procedures and seven emergency procedures were done on 84 patients, 22 of whom had bilateral endarterectomies. Indications for elective procedures included transient ischemic attacks, emboli from ulcerative plaques, high grade stenotic plaques on the same or opposite side in patients with old cerebrovascular accidents and asymptomatic bruits. Seven patients had emergency endarterectomies performed for acute strokes and these demonstrated a higher risk. They were grouped together as emergency procedures for comparison with the 99 elective procedures. Previous histories, risk factors, complications and outcome in the two groups are presented and discussed. Mortality in the elective cases was 2%, compared to 30% in the emergency cases with acute stroke. Surgical indications, operative technic and immediate and late results are discussed.