Carotid endarterectomy results from a state vascular society. Kentucky Vascular Surgery Society Study Group
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G N Yates1, T M Bergamini, S M George
1Department of Surgery and the Veterans Administration Medical Centers, the University of Louisville School of Medicine, Kentucky 40292, USA.
Purpose:
This study analyzes the results of carotid endarterectomy (CEA) performed statewide by members of the Kentucky Vascular Surgery Society (KVSS).
Methods:
Between September 1, 1991 and September 1, 1993, 22 vascular surgeons in the KVSS submitted 1490 CEAs to the vascular registry. Follow-up data were obtained on 986 (66%) CEAs performed on 889 patients (average age, 68 years).
Results:
Carotid endarterectomy was performed on 505 men and 384 women. Indications for operation were asymptomatic carotid stenosis (43%), transient ischemic attack (TIA; 27%), amaurosis fugax (13%), stroke (11%) and nonhemispheric symptoms (6%). A total of 384 cases had primary closure, and 602 had patch reconstruction following CEA. The combined stroke-mortality rate was 2.3% (10 strokes and 13 deaths). The combined stroke-mortality rate of CEA was 2.1% for patients treated by academic surgeons and 2.3% for those treated by community surgeons. Deaths were due to stroke (4), sepsis (5), cardiac complications (2), intracerebral hemorrhage (1) and cancer (1). Five patients had postoperative TIAs. After CEA, duplex scan surveillance was performed in 629 (64%) patients, with 23 (3.6%) residual/recurrent stenosis (10, 50%-75%; 13, 75%-99%) detected; 5 undergoing reoperation.
Conclusions:
These data support the efficacy and safety of CEA performed by a large number of vascular surgeons in both community and academic practice.