Late survival after carotid endarterectomy for transient ischemic attacks

Two hundred sixty-six consecutive patients with carotid transient ischemic attacks were treated by 310 carotid endarterectomies. The patients were followed up from 30 months to 12 years, and survival was charted by the life-table method. Comparison with an age- and sex-matched population from the same geographic region showed that survival after operation was not impaired unless there were risk factors from disease that was progressive or could not be well controlled. Hypertension and cardiac disease did not adversely affect survival-probably because they were generally well controlled and included the use of nonsynchronous coronary artery grafting when necessary. Those with impaired cardiac function severe enough to threaten perioperative myocardial infarction or acute irreversible cardiac failure during anesthesia were not recommended for operation.