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Published on: August 11, 2015
Outcomes of carotid endarterectomy: Insights from a single-center retrospective cohort study
Sultan AlSheikh, Badr Aljabri, Tariq Alanezi1
1From the Department of Surgery (AlSheikh, Aljabri, Al-Salman, Aldossary, Altuwaijri, Iqbal, Altoijry), Division of Vascular Surgery; from the College of Medicine (Alanezi, Almashat, Elmutawi, Aldoghmani), King Saud University, Riyadh, and from the Department of Surgery (Aldossary), Division of Vascular Surgery, Dammam Medical Complex, Dammam, Kingdom of Saudi Arabia.
Insights
Carotid endarterectomy for carotid artery stenosis showed low 30-day stroke and mortality rates. Careful patient selection and monitoring are key to managing perioperative risks and complications.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiology
Background:
- Carotid artery stenosis poses a significant risk for stroke.
- Carotid endarterectomy is a common procedure to mitigate this risk.
Purpose of the Study:
- To analyze the outcomes of carotid endarterectomy in patients with carotid artery stenosis.
- To assess the morbidity and mortality associated with the procedure in a tertiary care setting.
Main Methods:
- Retrospective cohort study from 2015-2022.
- Inclusion of patient demographics, risk factors, medications, and operative details.
- Primary outcomes: 30-day stroke and mortality; Secondary outcome: procedure morbidity.
Main Results:
- The study included 54 patients (57.4% male, mean age 66.9 years).
- 30-day stroke rate was 3.7%, and mortality rate was 1.9%.
- Surgical site hematoma (12.9%) was the most frequent complication; intensive care unit admission predicted complications.
Conclusions:
- Carotid endarterectomy demonstrated acceptable perioperative risks for carotid artery stenosis.
- Emphasizes the need for careful patient selection and postoperative monitoring.
- Suggests further research for predictive analyses to optimize treatment strategies.
Objectives:
To analyze the outcomes of carotid endarterectomy in individuals with carotid artery stenosis in the context of a tertiary care center.
Methods:
We carried out a retrospective cohort investigation between 2015-2022. Patient data includes demographics, risk factors, preoperative medications, and operative details. The primary outcomes were 30-day postoperative stroke and mortality rates, while the secondary outcome of the study was to assess the morbidity of the procedure.
Results:
The mean age of the 54 patients was 66.9±9.88 years, and 57.4% were men. The 30-day stroke rate was 3.7%, and the mortality rate was 1.9%. Most patients did not develop postoperative complications; however, surgical site hematoma was the most common complication encountered (12.9%). Long-term follow-up showed disease regression in 68.5% of patients, with a minority of patients developing ipsilateral restenosis. Admission to an intensive care monitoring unit was the only independent predictor of postoperative complications.
Conclusion:
This study provided insights into the outcomes of carotid endarterectomy in patients with carotid artery stenosis, emphasizing the importance of careful patient selection and postoperative monitoring. Perioperative risks, including stroke and mortality, were within acceptable limits. Further research incorporating structured and non-structured data for predictive analyses, should explore refining patient profiling and optimizing treatment approaches for different carotid artery stenosis clinical and morphological presentations.
