Surgical outcome of carotid artery disease: analysis of 367 carotid endarterectomies.

Carotid endarterectomy is a method of prophylaxis. A total of 367 carotid endarterectomies in 335 patients were performed during the period of 1989-1997: 222 (66.3%) were symptomatic and 113 (33.7%) asymptomatic patients. In all, 262 (78.2%) had unilateral, 41 (12.2%) contralateral occlusion and 32 (9.6%) bilateral artery disease. All were operated on under general anesthesia without using shunt or patch. Of the patients with bilateral occlusive disease, 17 underwent simultaneous and 15 staged endarterectomy. The mortality rate of the first 30 postoperative days was 1.19% and the mortality/stroke rate 2.38%. Transient neurogenic dysfunction occurred in 3.68%, myocardial ischemia in 0.89%, and postoperative hypertension in 16.7%. Endarterectomy of symptomatic and asymptomatic patients with unilateral localisation, contralateral occlusion or bilateral occlusive disease remains a highly acceptable prophylactic method. The future will show whether other endovascular procedures affect the broad application of carotid endarterectomy.