Indications and Outcome of Carotid Endarterectomy (CEA): A Single Centre Experience
Mohamed S M Elshikhawoda1, Sohaib Jararaa1, Steven H S Tan2
1Vascular Surgery, Glan Clwyd Hospital, Rhyl, GBR.
Insights
Carotid endarterectomy (CEA) is highly effective for symptomatic carotid artery stenosis. Patient suitability and timely intervention are key to successful outcomes in this gold standard surgical treatment.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiology
Background:
- Stroke is a leading cause of disability and mortality worldwide.
- Carotid artery stenosis is a significant risk factor for stroke.
- Carotid endarterectomy (CEA) is a primary intervention for symptomatic stenosis.
Purpose of the Study:
- To evaluate the indications and outcomes of carotid endarterectomy (CEA).
- To analyze patient demographics and comorbidities influencing CEA results.
- To assess the efficacy and complication rates of CEA in a clinical setting.
Main Methods:
- Retrospective, observational study design.
- Data collected from Glan Clwyd Hospital (January 2018 - January 2023).
- Analysis of 150 patients with symptomatic carotid artery stenosis undergoing CEA.
Main Results:
- Majority of patients were male (69.3%), mean age 71.1 years.
- High prevalence of comorbidities: smokers (48.7%), hypertension (34%), diabetes (46.7%), COPD (73.3%).
- Low complication rates: cardiac event (3.3%), TIA (3.3%), stroke (0.6%), hemorrhage (2.6%), SSI (2%), mortality (1.3%), nerve injury (1.3%); 85.6% had no complications.
Conclusions:
- Carotid endarterectomy (CEA) is advantageous for symptomatic stenosis in suitable patients.
- Efficacy depends on stenosis severity, timing of intervention, and patient's overall health.
- CEA remains the gold standard for surgical management of symptomatic carotid disease.
Abstract:
Background Stroke is a prevalent ailment that impacts a substantial number of individuals globally, resulting in both physical impairment and mortality. One of its major causes is carotid artery stenosis. The symptoms and degree of stenosis are key indications for carotid endarterectomy (CEA). In this study, we highlight the indications and outcomes of carotid endarterectomy in our center. Methods This is a descriptive, retrospective, observational study. Data of patients who underwent CEA at Glan Clwyd Hospital from January 2018 to January 2023 was retrieved. The study sample consisted of patients diagnosed with symptomatic carotid artery stenosis who had CEA at Glan Clwyd Hospital. The data was analyzed using statistical software SPSS (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). Results A total of 150 patients were enrolled in the study. A majority of the patients were male, accounting for 69.3% (n = 104), and had a mean age of 71.1 ± 9.9 standard deviation. A majority of the patients were smokers (48.7%) and had additional medical conditions, including hypertension (34%), ischemic heart disease (17.3%), chronic obstructive pulmonary disease (73.3%), and diabetes (46.7%). Nevertheless, the remaining comorbidities were less common. The outcome of the CEA among the patients was cardiac event 3.3% (n = 5); transient ischemic attack (TIA) 3.3% (n = 5); stroke 0.6% (n = 1); hemorrhage 2.6% (n = 4); surgical site infection 2% (n = 3); perioperative mortality 1.3% (n = 2); and cranial nerve injury 1.3% (n = 2). However, no complications were reported in most of the patients, 85.6% (n = 128). Conclusion An endarterectomy is quite advantageous for treating symptomatic stenosis. The findings can be applied to patients who are physically suitable for surgery. The efficacy of endarterectomy is contingent upon not only the severity of carotid stenosis but also various other parameters, such as the time elapsed between the presenting event and the surgical intervention, as well as the patient's overall medical condition. However, the CEA is the gold standard in surgical management for symptomatic carotid disease.
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