Carotid endarterectomy. Results in asymptomatic and symptomatic patients.

Objective evidence of the benefit of carotid endarterectomy in preventing stroke and its significant sequelae has recently been demonstrated by prospective trials. The salutary results depend on meeting strict operative outcome criteria as established by the American Heart Association. We retrospectively analyzed 265 consecutive carotid endarterectomies performed in 248 patients during 1 year at our institution. The perioperative mortality rate was 0; late mortality occurred 6 months postoperatively in 1 of 2 patients who experienced a perioperative stroke. The combined perioperative mortality and stroke rate was 0.8%. The combined mortality and stroke rate in patient subgroups was 0.7% (1/151) for asymptomatic patients, 1.6% (1/64) for symptomatic patients who had presented with a transient ischemic attack, and 0% (0/50) for symptomatic patients who had presented with a completed stroke. We conclude that the objective postoperative benefits of carotid endarterectomy in treating extracranial cerebrovascular disease can be achieved with low perioperative patient morbidity.