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Related Experiment Video

Updated: Jan 31, 2026

Carotid Artery Infusions for Pharmacokinetic and Pharmacodynamic Analysis of Taxanes in Mice
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Weekend Effect in Carotid Endarterectomy.

Thomas F X O'Donnell1,2, Marc L Schermerhorn1, Patric Liang1

  • 1From the Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA (T.F.X.O., M.L.S., P.L., C.L., N.J.S., M.C.W.).

Stroke
|December 21, 2018
PubMed
Summary

Weekend surgery for carotid endarterectomy (CEA) is linked to worse patient outcomes, including higher stroke or death rates, especially for asymptomatic patients and those with stroke symptoms. Avoid weekend CEA unless urgent revascularization is needed after a transient ischemic attack.

Keywords:
carotid endarterectomydeathlength of staymedicarepatientsstroke

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Area of Science:

  • Vascular Surgery
  • Health Services Research
  • Patient Outcomes

Background:

  • The
  • weekend effect,
  • whereby surgery on weekends is associated with poorer outcomes, has not been previously investigated for carotid endarterectomy (CEA).

Purpose of the Study:

  • To determine if a weekend effect exists for carotid endarterectomy (CEA).
  • To assess the impact of weekend CEA on in-hospital stroke or perioperative death and length of stay.

Main Methods:

  • Analysis of 86,123 isolated CEA procedures from the Vascular Quality Initiative (2003-2018).
  • Primary outcome: in-hospital stroke or perioperative death (stroke/death).
  • Propensity score matching and inverse probability weighted regression were used to adjust for patient and hospital factors.

Main Results:

  • Weekend CEA was associated with significantly higher odds of stroke/death in asymptomatic patients (OR, 2.3) and symptomatic patients (OR, 1.7).
  • Asymptomatic patients undergoing weekend CEA had significantly higher odds of prolonged length of stay (OR, 3.6).
  • The increased stroke/death risk in symptomatic patients was driven by those presenting with stroke, not transient ischemic attack.

Conclusions:

  • A significant weekend effect was observed in CEA, with higher stroke/death rates and prolonged length of stay for weekend procedures in asymptomatic patients and those presenting with stroke.
  • No evidence of a weekend effect was found for patients with transient ischemic attack.
  • Weekend CEA should generally be avoided, except in cases requiring expedited revascularization following a transient ischemic attack.