[Morbimortality in carotid endarterectomy]
J M Castilla1, P Delgado, V Martín
1Servicio de Neurocirugía, Hospital General Yagüe, Burgos.
Objective:
To assess perioperative and long-term morbidity in patients diagnosed of carotid stenosis submitted to our Department for surgical endarterectomy.
Patients And Methods:
A retrospective study of 97 endarterectomies performed by six neurosurgeons in 90 patients treated between January 1995 and December 2003. Ten patients were women. Average mean age was 69 years-old (range 38-86). Seven patients were treated bilaterally. Eighty-four stenosis were greater than 70%. Annual number of interventions per surgeon was 3 (range 0-10). The median follow-up was 121 days, (range 8-2106).
Results:
Four patients died perioperatively and other 4 ones developed new neurologic deficits. The combined morbidity-mortality rate was 8.9% of the patients and 8.2% of the surgeries. Four patients needed reintervention, because of immediate postoperative new deficit (one) and surgical hematoma (three). Transient peripheral nerve palsy occurred in 8 patients and 21 medical complications were registered. In the long term, 7 patients died (6 because of cancer and 1 because of cardiopathy) and 5 presented neurologic events (3 ipsilateral and 2 in other locations). Last postoperative image control, performed on average after 52 days (0-2832), revealed 7 stenosis of the treated artery.
Conclusions:
Carotid endarterectomy can be safely performed in low-volume centers with acceptable results and reasonable morbidity and mortality rates when simple techniques are used. We consider crucial to evaluate self complications and results in order to improve them.
