Kumar K, Tang K K, Thomas J, Chumpon C
Department of Neurosurgery, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Med J. 2002 Dec;43(12):628-31.
To review the outcome of a consecutive series of patients undergoing carotid endarterectomy in a low volume setting.
Retrospective case review.
During an 11-year period we performed 50 elective carotid endarterectomies on patients with symptomatic severe carotid stenosis: Ages of patients raised from 40 to 87 years (mean 68 years), 88% were Chinese, 6% Malay and 4% Indian. Twenty-eight percent had coronary artery disease, 64% hypertension, 27% diabetes mellitus, 50% hyperlipidaemia, and 52% were smokers. None of the patients had prior neck surgery or radiotherapy.
There were no deaths in this series of 50 cases. Ninety-eight percent of our patients came through surgery without major neurologic deficit. One patient (2%) suffered a major perioperative stroke. Minor neurologic sequelae included one patient (2%) with a mild non-disabling stroke, two patients (4%) with peri-operative TIA without significant sequelae; two patients (4%) with transient cranial nerve weakness (one vagus, one facial nerve).
The surgical outcomes in this series are comparable to that from larger series. Carotid endarterectomy can be safely done in a low volume setting.
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