Complications during the waiting period for carotid endarterectomy

We conducted a retrospective analysis to determine the number of cerebrovascular complications occurring in the period between initial presentation and operation in patients undergoing carotid endarterectomy. The notes of patients undergoing carotid endarterectomy during a 2-year period were used to quantify delays between initial presentation and surgery and complications occurring in this time period. A group of 49 patients was analyzed. The median time period between referral following initial cerebrovascular event and carotid endarterectomy was 62 days. During this time period 12 (24.5%) ischemic complications occurred including six transient ischemic attacks. Delays occurred at a variety of levels but included a median of 36 days before patients seen in the stroke clinic were referred to a surgeon and a median of 23 days before operation once patients had seen a surgeon. Significant delays still exist between initial presentation and carotid endarterectomy and can lead to further ischemic episodes prior to surgery.