Regional Performance of Carotid Endarterectomy

Abstract

Background and Purpose Guided by the findings of randomized controlled trials evaluating carotid endarterectomy (CEA), we examined the appropriateness of CEAs performed in our city and determined the incidences and risk factors for postoperative stroke, death, and cardiac complications. Methods Using health records, we retrospectively reviewed 291 consecutive CEAs performed in our region over 18 months. Based on randomized controlled trial results and standardized remeasurements of angiographic carotid stenoses, indications for CEA were considered appropriate for symptomatic carotid stenoses ≥70%, uncertain for Conclusions Almost 1 in 5 patients underwent CEA inappropriately, which was most commonly due to apparent overestimation of stenosis severity, and half had uncertain indications. Our high complication rate possibly negated any overall surgical benefit in the large group of asymptomatic patients.