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Rates of Occurrence in Asymptomatic and Symptomatic Patients

John S. White, MD; Kenneth R. Sirinek, MD, PhD; H. David Root, MD, PhD; Waid Rogers, MD, PhD

Arch Surg. 1981;116(4):409-412.

Abstract
• During a six-year period ending December 1979, a retrospective study of 252 carotid endarterectomies in 211 patients was undertaken to review morbidity and mortality, and factors related to them. For purposes of the study, patients were categorized into asymptomatic and symptomatic groups. Indications for operation were internal carotid artery stenosis that occluded 50% or more of the vessel, an ulcerated plaque proved by angiography, or both. There were no postoperative deaths or neurological complications in the asymptomatic group. In the symptomatic group, there was an overall postoperative mortality of 2% and a stroke rate of 2%. All postoperative CNS deaths and strokes occurred in patients in whom there was difficulty in controlling blood pressure postoperatively. We conclude that with regard to carotid endarterectomy for treatment of extracranial occlusive disease (1) there is an acceptable morbidity and mortality in the symptomatic patient, (2) in the asymptomatic patient the procedure is associated with minimal complications, and (3) strict control of blood pressure in the immediate postoperative period is a critical factor in preventing neurological morbidity and mortality.

(Arch Surg 1981;116:409-412)

Author Affiliations
From the Surgical Service, Audie L. Murphy Memorial Veterans Hospital, and the Department of Surgery, University of Texas Health Science Center, San Antonio.

Footnotes
Accepted for publication Nov 26, 1980.

Read at the Fourth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Alexandria, Va, May 11, 1980.

Reprint requests to the Department of Surgery, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284 (Dr Rogers).

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