Prophylactic carotid endarterectomy for asymptomatic bruit. A look at cardiac risk
P. A. Burke, A. D. Callow, T. F. O'Donnell Jr, J. J. Kelly and H. Welch
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.
