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Selection process for surgeons in the Asymptomatic Carotid Atherosclerosis Study.
W S Moore1, C L Vescera, J T Robertson
1Department of Surgery, UCLA Center for the Health Sciences 90024-6904.
Stroke
|November 1, 1991
Summary
Surgeons performing carotid endarterectomy for asymptomatic stenosis met strict criteria, ensuring high-quality patient care. Approved surgeons demonstrated low neurological morbidity and mortality rates in this large study.
Area of Science:
- Vascular Surgery
- Neurology
- Clinical Trials
Background:
- The Asymptomatic Carotid Atherosclerosis Study is a prospective, multicenter trial evaluating carotid endarterectomy for asymptomatic, hemodynamically significant stenosis.
- This report details the rigorous surgeon selection process implemented for the trial.
Purpose of the Study:
- To describe the criteria and process for selecting qualified surgeons for the Asymptomatic Carotid Atherosclerosis Study.
- To ensure a high standard of surgical expertise and patient safety in the trial.
Main Methods:
- Surgeons needed to perform at least 12 carotid endarterectomies annually.
- A maximum combined neurological morbidity and mortality rate of 5% (all indications) and 3% (asymptomatic patients) was required, based on the last 50 procedures.
- The Surgical Management Committee established these stringent qualification guidelines.
Main Results:
- 164 surgeons applied; 117 were approved, 17 rejected, and 30 unreviewed.
- Approved surgeons performed 5,641 endarterectomies in total.
- The combined mortality and neurological morbidity rate for approved surgeons was 2.3%.
Conclusions:
- The experience represents one of the largest carotid endarterectomy series reported.
- The low morbidity and mortality rates of approved surgeons align with American Heart Association recommendations.
- The selection process ensured the participation of highly qualified surgeons, attesting to the study's overall quality.