Zeiger H E, Zampella E J, Naftel D C, McKay R D, Varner P D, Morawetz R B
Department of Surgery, University of Alabama at Birmingham Medical Center.
J Neurosurg. 1987 Oct;67(4):540-4. doi: 10.3171/jns.1987.67.4.0540.
Carotid endarterectomy may carry a substantial risk of morbidity and mortality from major stroke, thus offsetting any statistical benefit in reduction of future stroke. Because of the disturbing ranges in the incidence of stroke morbidity and mortality reported from the several institutional series studying carotid endarterectomy, the authors undertook a prospective review of 142 consecutive carotid endarterectomies performed for symptomatic atherosclerotic occlusive vascular disease on the neurosurgical service. The University of Alabama Hospital. Preoperative risk assessment was performed in each case according to the Mayo Clinic classification system. The overall mortality rate was 1.4% and the major stroke morbidity rate was 0.7%, for a combined major morbidity and mortality rate of 2.1%. The incidence of minor neurological morbidity was 1.4%. There was no morbidity or mortality in the Grade I and II (low-risk) patient groups. This low combined major morbidity and mortality rate of 2.1% for carotid endarterectomy causes the surgical stroke-free survival curve to intersect the medical stroke-free survival curve at an earlier point in time, and thus demonstrates the greater reduction in risk of stroke which accrues over time for the surgically treated patient.
颈动脉内膜切除术可能会因严重中风而带来较高的发病和死亡风险，从而抵消了在降低未来中风发生率方面的任何统计学益处。由于在几项研究颈动脉内膜切除术的机构系列报告中，中风发病率和死亡率的范围令人不安，作者对神经外科服务中因症状性动脉粥样硬化闭塞性血管疾病而连续进行的142例颈动脉内膜切除术进行了前瞻性回顾。阿拉巴马大学医院。根据梅奥诊所分类系统对每个病例进行术前风险评估。总死亡率为1.4%，主要中风发病率为0.7%，主要发病和死亡率合并为2.1%。轻微神经功能发病率为1.4%。I级和II级（低风险）患者组无发病或死亡情况。颈动脉内膜切除术这种2.1%的低主要发病和死亡率组合，使得手术无中风生存曲线在更早的时间点与药物治疗无中风生存曲线相交，从而表明随着时间推移，接受手术治疗的患者中风风险降低得更多。
