[Complication rates of carotid endarterectomy in Taleghani and lranmehr hospitals, Tehran, Iran]

ABSTRACT

Previous studies demonstrated the efficacy of carotid endarterectomy [CEA] in reducing the risk of strokes and deaths in selected patients afflicted with carotid artery stenosis. Selection of patients for CEA depends on degree of stenosis, whether patient is symptomatic or asymptomatic and complication rate of CEA; so, it has been recommended that surgical departments publish their complication rates. As there were no data regarding complication rates of CEA in Iran, this study was performed. We performed a retrospective study of all CEAs performed in Taleghani and Iranmehr hospitals till March 2001.In-hospital mortality or strokes were determined by review of patients' files. Telephone interview of patients or their families achieved additional follow-up for complications occurring within 30 days of CEA. The cohort consisted of 246 consecutive cases of CEA. There were 12 [6.4%] strokes and 4[2.1%] deaths in Iranmehr and 2[3.4%] strokes and 3[5.2%] deaths in Taleghani hospitals. Overall complication rate was 8.5%. Risk factors for stroke or death were history of diabetes mellitus and, unexpectedly, history of previous CEA on contra lateral side. According to the results of this study, CEA is appropriate for symptomatic patients with stenosis greater than 70% and not recommended for asymptomatic patients. Determining complication rates of CEA in other centers will help the selection of appropriate patients for CEA