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Carotid endarterectomy in a vascular fellowship training program: good results with a consistent technique
A M Graham1, G C Salasidis, A M Ferneini
1Division of Vascular Surgery, Robert Wood Johnson University Hospital, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019.
Objective:
To find out whether carotid endarterectomy performed by senior residents or vascular fellows in a vascular fellowship program with a uniform technical approach can give results equal to or better than the acceptable standard.
Design:
A case study with follow-up ranging from 121 to 1369 days.
Setting:
A university teaching hospital.
Patients:
Two hundred and one consecutive patients operated on between May 1989 and June 1993.
Interventions:
Isolated carotid endarterectomy.
Main Outcome Measures:
Neurologic findings, cardiovascular complications and local wound problems after carotid endarterectomy.
Results:
There were no deaths, one permanent stroke and two significant deficits from which the patients fully recovered.
Conclusions:
Carotid endarterectomy can be performed by senior surgical residents and vascular fellows within a vascular fellowship program, with a perioperative stroke and death rate of less than 1% when a uniform approach is used.