The Assessment of Outcome in Carotid Artery Operations Performed in the Period 1997– 2009

Czech version

Authors: Z. Šilhart ¹; J. Hillová Mannová ²; P. Kysela ¹; I. Hamtilová ¹; J. Ničovský ¹; P. Ševčík ²; Z. Kala ¹
Authors‘ workplace: LF MU a FN Brno Chirurgická klinika ¹; LF MU a FN Brno Klinika anesteziologie, resuscitace a intenzivní medicíny ²
Published in: Cesk Slov Neurol N 2010; 73/106(3): 294-298
Category: Short Communication

Overview

Introduction:
Carotid endarterectomy is a frequently performed operation in the Department of Surgery (vascular surgery) of the Faculty Hospital, Brno. An audit of carotid artery operations was made covering the last 13 years and the results are presented in this article. Results: 1,957 patients underwent carotid artery operations in the years 1997– 2009. Carotid endarterectomy as a treatment for carotid occlusive disease was indicated in 96% (1,882) patients (symptomatic carotid stenosis 1,346 patients, asymptomatic 536). The traditional longitudinal arteriotomy was chosen as operating technique in 1,827 patients, with primary closures in 30% (546) and patch angioplasty in 70% (1,281). Patch types broke down into vein patches (1,110) and synthetic patches (171), while shunts were inserted in 1,179 patients. General anaesthesia was performed in 90% (1,762), cervical plexus block in 10% (195). The frequency of postoperative complications was: stroke, TIA 19 (1%); operation revision for bleeding 15 (0.8%); ACI thrombosis 8 (0.45%); nerve injuries 9 (0.5%); and carotid re‑stenosis 25 (1.3%). The 30- day mortality figure was 7 (0.35%). Conclusion: Carotid endarterectomy still remains a gold standard for the treatment of carotid occlusive disease. The benefits of the procedure depend on institutional outcomes. Giving preference to carotid artery operations in high‑volume centres with extensive experience and good results enables patients to undergo this operation with lower frequency of postoperative complications and mortality and may contribute to better quality of life after carotid endarterectomy.

Key words:
carotid stenosis – carotid endarterectomy – postoperative complications – mortality

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