Routine completion study during carotid endarterectomy is not necessary

Area of Science:

• Vascular Surgery
• Neurology
• Medical Device Technology

Background:

• Completion studies are often recommended after carotid endarterectomy (CE) to ensure technical success.
• Routine use of completion studies during CE is debated, with varying clinical practices.
• Assessing the necessity of routine completion studies is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To evaluate the outcomes of carotid endarterectomy (CE) performed without the routine use of completion studies.
• To determine the rate of postoperative neurologic events and mortality in patients undergoing CE without routine completion studies.
• To assess the long-term patency of the treated arteries in the absence of routine completion studies.

Main Methods:

• Retrospective chart review of 417 patients who underwent 455 carotid endarterectomies (CE).
• Data collected included demographic features, risk factors, ipsilateral neurologic events within 30 days, and mortality.
• Long-term follow-up data on arterial patency was also analyzed.

Main Results:

• Four hundred fifty-five carotid endarterectomies (CE) were performed without routine completion studies.
• A total of 14 postoperative neurologic events and 4 deaths were recorded.
• Of the 14 arteries with events, 10 remained open long-term; 1 occlusion was not explored, and 2 patients were lost to follow-up.

Conclusions:

• Carotid endarterectomy (CE) can be safely performed without the routine use of completion studies.
• An acceptable postoperative neurologic complication rate can be achieved with careful surgical technique.
• The routine use of completion studies during CE may not be necessary, potentially streamlining the procedure.