Brott T G, Labutta R J, Kempczinski R F
JAMA. 1986 May 16;255(19):2609-12.
Changes in the practice of carotid endarterectomy were studied by review of all endarterectomies performed in the greater Cincinnati area during 1980 and from July 1983 through June 1984. The number of operations rose from 431 to 750 (74% increase). The perioperative stroke rate fell from 8.6% in 1980 to 5.1% in 1983-1984; operative mortality declined from 2.8% to 2.3%; and the combined stroke or death rate declined from 9.5% to 6.5%. Asymptomatic carotid artery disease was the indication for 50% of the endarterectomies during both time periods. The combined stroke or death rate for asymptomatic patients declined from 6.9% to 5.3%, but both rates were higher than the 3% suggested as acceptable for prophylactic carotid endarterectomy. We conclude that carotid endarterectomy is becoming an increasingly common procedure, that morbidity continues to decline, and that mortality continues to be significant. Citywide surgical morbidity and mortality remain excessive for patients with asymptomatic carotid disease.
通过回顾1980年以及1983年7月至1984年6月在大辛辛那提地区进行的所有颈动脉内膜切除术，研究了该手术操作的变化情况。手术数量从431例增至750例（增长了74%）。围手术期卒中率从1980年的8.6%降至1983 - 1984年的5.1%；手术死亡率从2.8%降至2.3%；卒中或死亡率从9.5%降至6.5%。在这两个时间段内，无症状性颈动脉疾病都是50%的内膜切除术的指征。无症状患者的卒中或死亡率从6.9%降至5.3%，但这两个比率均高于预防性颈动脉内膜切除术可接受的3%。我们得出结论，颈动脉内膜切除术正变得越来越常见，发病率持续下降，死亡率仍然显著。对于无症状性颈动脉疾病患者，全市范围内的手术发病率和死亡率仍然过高。
