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Prophylactic Carotid Endarterectomy for Asymptomatic BruitA Look at Cardiac Risk
Peter A. Burke;
Allan D. Callow, MD;
Thomas F. O'Donnell, Jr, MD;
John J. Kelly, MD;
Harold Welch
Arch Surg. 1982;117(9):1222-1227.
Abstract
• We assessed the influence of preoperative cardiac risk factors in 57 patients undergoing 70 prophylactic carotid endarterectomies (PCE) and found that: (1) 47 (83%) had at least one cardiac risk factor and (2) nine of 15 deaths occurring in the late follow-up period (40 to 120 months) were due to cardiac causes. Perioperatively, one patient sustained a mild stroke. Although the cumulative stroke-free occurrence rate was kept to less than 6% over the five-year period, cardiac morbidity and mortality greatly influenced the quality of life after PCE. Therefore, PCE is suggested only for patients who have minimal preoperative cardiac risk factors or for those patients whose cardiac risk factors can be improved by medical therapy.
(Arch Surg 1982;117:1222-1227)
Author Affiliations
From the Department of Surgery, Tufts-New England Medical Center, Boston.
Footnotes
Accepted for publication May 18, 1982.
Read before the eighth annual meeting of the New England Society for Vascular Surgery, Waterville Valley, NH, Sept 25, 1981.
Reprint requests to Department of Surgery, Tufts-New England Medical Center, 171 Harrison Ave, Boston, MA 02111 (Dr Callow).
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