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Carotid endarterectomy: changing practice patterns

D Mukherjee1

  • 1Fairfax Hospital, Falls Church, VA, USA.

The Journal of Cardiovascular Surgery
|February 11, 1999
PubMed
Summary
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Carotid endarterectomy offers excellent patient outcomes with low stroke and mortality rates. This surgical procedure is both medically effective and cost-efficient for patients.

Area of Science:

  • Vascular Surgery
  • Neurosurgery
  • Cardiovascular Medicine

Background:

  • Cost-effective carotid endarterectomy is associated with favorable outcomes.
  • Key indicators of success include low morbidity and short hospital stays.
  • Selective utilization of non-invasive preoperative diagnostic tests is a component of cost-effectiveness.

Purpose of the Study:

  • To evaluate the outcomes of carotid endarterectomy performed by a single surgeon.
  • To assess the safety and efficacy of carotid endarterectomy in a community hospital setting.
  • To determine the impact of evolving diagnostic techniques on surgical outcomes.

Main Methods:

  • A retrospective review of 218 consecutive carotid endarterectomy procedures.
  • Procedures were performed by a solo surgeon over a seven-year period.

Related Experiment Videos

  • Analysis included perioperative outcomes, diagnostic methods, anesthesia, and patient discharge status.

    • Main Results:

    • Achieved a perioperative stroke rate of 1.4% and a mortality rate of 0.45%.
    • Increasing use of Duplex ultrasonography and magnetic resonance angiography without invasive angiography in recent years.
    • High rates of same-day discharge (48% overall, 75% in 1995-1996) were observed.

    Conclusions:

    • Carotid endarterectomy can be performed with minimal morbidity and mortality.
    • The procedure is associated with short hospital stays.
    • Carotid endarterectomy is a highly effective surgical intervention from both medical and economic perspectives.