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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Results and future of carotid endarterectomy in a medium-sized Finnish central hospital
J J Jokinen1, H M T Huusari, J Y Lehtonen
1Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland. janne.jokinen@helsinki.fi
Background And Aims:
Carotid endarterectomies (CEA) should, by general agreement, be performed only at specialised institutions and on patients who are expected to have a low rate of complications, i.e., a 6% surgical risk for patients with symptomatic and a 3% risk for patients with asymptomatic carotid artery disease. We have reviewed the midterm results after CEA in a medium-sized Finnish central hospital to audit whether our results fulfil current quality standards.
Patients, Materials And Methods:
There were 116 consecutively operated patients at the Päijät-Häme Central Hospital during the years 1999-2003 on whom 122 CEAs were made. All CEAs were performed by conventional methods and shunts and patches were used when necessary.
Results:
The overall survival rate was 81.0% during the 3.6 +/- 1.5 years [range 1.3-6.3 years] follow-up. The incidence of early major stroke was 2.5% and of late major stroke 1.6%. Other complications included cranial nerve deficit (2.5%), wound haematoma (3.3%) and postoperative hypertension (3.3%) or hypotension (2.5%). Significant changes in medication were needed after surgery in several patient subgroups.
Conclusions:
The results of CEA at the Päijät-Häme Central Hospital are at least acceptable. The primary prevention of strokes with pharmacotherapy needs aggressive improvement.