Why the study?
The long-term benefit of carotid endarterectomy had not been fully investigated in average-volume centers.
What are the long-term outcomes of carotid endarterectomy in symptomatic versus asymptomatic patients treated at an average-volume community hospital?
What are the long-term outcomes of carotid endarterectomy in symptomatic versus asymptomatic patients treated at an average-volume community hospital?
Carotid endarterectomy performed in a medium-volume community hospital demonstrates excellent long-term safety and efficacy, with higher combined event-free survival in asymptomatic compared to symptomatic patients.
Long-term CEA data from medium-volume centers remain limited; this retrospective analysis leaves open the need for prospective multicenter confirmation.
Background Long-term benefit of carotid endarectomy has not yet been fully investigated in average volume centers. Thus our purpose is to evaluate long-term results of carotid endarterectomies at a medium-volume hospital.Methods A retrospective analysis of carotid artery stenosis operated between 2008 and 2017 in a community hospital was done. Demographic and postoperative outcomes were evaluated in short and long-term by Kaplan–Meier survival analysis.Results 167 procedures in 159 patients were included. Average age was 72 years, and 65% were men. Twenty-nine percent of the patients were symptomatic and the rest asymptomatic. Median hospitalization was 3 (IQR 3–4) days and the mean follow-up was 56 months. No hospital mortality was recorded. At 120-month follow-up, freedom of stroke was 97.4%, death 97.3%, restenosis, 98.7% and all combined events 92.9% (log rank p = .042) Combined event-free survival was 84.4% in symptomatic patients, and 96.1% in asymptomatic patients (log rank p = .025).Conclusions In a medium-volume hospital combined event-free survival was 84.4% in symptomatic patients and 96.1% in asymptomatic at a 10-year follow-up.
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Gallesio et al. (2020) studied this question.
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