Carotid endarterectomy the influence of the standard surgical technique on the outcome of surgery

ABSTRACT

Carotid endarterectomy has been validated as effective therapy for both symptomatic and asymptomatic carotid stenosis. However, many aspects of this procedure remain controversial. This retrospective study was carried out to test the influence of standardization of the surgical technique on the final outcome. During the last 5 years, at Dhahran health center, we have been utilizing internal shunting and patch angioplasty as a routine practice and on selective basis as previously practiced in the previous 5 years experience. Computerized charts and medical records of cases underwent CEA between 2000 and 2004 were reviewed. The patient data and procedure outcome were compared with our initial reported experience between 1994 and 1999. Thirty-four patients underwent 37 carotid endarterectomies between February, 2000 and December, 2004. There was no significant change in our population demographic data, underlying risk factors or the indications for the surgery. The overall stroke rate was 5.4% [2 cases] and mortality was 2.7% [one patient]. None of the patients developed postoperative cardiac events, wound infection or cranial nerve injury. The overall operative complication was significantly lower in the past 5 years than previously reported from the same institute, 5.9% and 25.7% respectively [P< 0.05]. Conclusions: Over the past 5 years of our experience there is a trend towards improved outcome of CEA with standardization of a surgical technique that is mastered by the surgical team