Abstract

CASTILLA, J.M. et al. Morbimortality in carotid endarterectomy. Neurocirugía [online]. 2005, vol.16, n.2, pp.93-107. ISSN 1130-1473.

Objective. To assess perioperative and long-term morbidity in patients diagnosed of carotid stenosis submitted to our Department for surgical endarterectomy. Patients and methods. A retrospective study of 97 endarterectomies performed by six neurosurgeons in 90 patients treated between january 1995 and december 2003. Ten patients were women. Average mean age was 69 years-old (range 38-86). Seven patients were treated bilateraly. Eighty-four stenosis were greater than 70%. Annual number of interventions per surgeon was 3 (range 0-10). The median follow-up was 121 days, (range 8-2106). Results. Four patients died perioperatively and another 4 developed new neurologic deficits. The combined morbiditymortality rate was 8'9% of the patients and 8'2% of the surgeries. Four patients needed reintervention, because of immediate postoperative new deficit (one) and surgical hematoma (three). Transient peripheral nerve palsy occurred in 8 patients and 21 medical complications were registered. In the long term, 7 patients died (6 because of cancer and 1 because of cardiopathy) and 5 presented neurologic events (3 ipsilateral and 2 in other locations). Last postoperative image control, performed on average after 52 days (0-2832), revealed 7 estenosis of the treated artery. Conclusions. Carotid endarterectomy can be safely performed in low-volume centers with acceptable results and reasonable morbidity and mortality rates when simple techniques are used. We consider crucial to evaluate self complications and results in order to improve them.

Keywords : Carotid endarterectomy; Complications; Mortality; Quality control; Risk assessment; Patient selection.

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