Arteriography after carotid endarterectomy.

Of 55 patients undergoing carotid endarterectomy, 16 had abnormal postoperative angiograms by accepted literature criteria. Five of the 16 were symptomatic. The other 11 were neurologically stable or improved from their preoperative condition. None of the 16 patients underwent reoperation. Of those 11 who had abnormal postoperative angiograms but a good clinical result, four had a second postoperative angiogram some months later that demonstrated marked improvement in the appearance of the endarterectomy site. Patients undergoing carotid endarterectomy should not be subjected to routine postoperative angiography without clinical indications nor should they undergo reoperation on the basis of angiographic findings alone without consideration of their clinical status.