Outcome following carotid endarterectomy: lessons learned from a large international vascular registry

Eur J Vasc Endovasc Surg. 2011 Jun;41(6):735-40. doi: 10.1016/j.ejvs.2011.02.028. Epub 2011 Mar 29.

Abstract

Objectives: The aim of the study was to assess if technical and patient-related factors are related to outcome after carotid surgery.

Design: Vascunet is a collaboration of national and regional registries with 10 contributing countries.

Patients and methods: Data from 48,035 carotid endarterectomies (CEAs) performed in 383 centres, during 2003-2007, were merged into a common database.

Results: CEA was performed without patch (34%), with patch (40%) or with eversion (26%) in 74% for symptomatic and in 26% for asymptomatic disease. Overall (in-hospital and 30-day) mortality was 0.45%. Type of CEA or anaesthesia did not affect mortality, nor did contralateral occlusion. Mortality was higher in patients above the age of 75 years, for both genders (p < 0.05). The overall (in-hospital) stroke rate was 1.9%, the method of anaesthesia did not affect stroke rate. It was higher in patients with contralateral occlusion (4.6% vs. 2.5%, p = 0.002). Standard CEA without patch had a higher stroke rate than when a patch was used (2.3 vs. 1.7%, p = 0.015). Female patients >75 years had a higher stroke rate than younger women (2.0% vs. 1.6%, p = 0.078); this difference was not observed in men.

Conclusions: Although there are limitations with registry data, the large number of cases involved provides useful information on outcomes, supplementing data from the randomised clinical trials (RCTs).

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Anesthesia
  • Australasia / epidemiology
  • Carotid Stenosis / complications
  • Carotid Stenosis / mortality
  • Carotid Stenosis / surgery*
  • Endarterectomy, Carotid*
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Registries
  • Sex Factors
  • Stroke / epidemiology
  • Stroke / prevention & control
  • Survival Rate
  • Treatment Outcome