Key result
Carotid stenosis detected before general surgery was associated with a perioperative stroke risk of approximately 3.6%, a risk insufficient to mandate prophylactic endarterectomy.
Why the study?
Does known carotid stenosis increase the perioperative risk of stroke enough to mandate prophylactic endarterectomy in patients undergoing general surgery?
Observational (n=284)
Does known carotid stenosis increase the perioperative risk of stroke enough to mandate prophylactic endarterectomy in patients undergoing general surgery?
The perioperative stroke risk in patients with carotid stenosis undergoing general surgery is approximately 3.6%, which does not appear sufficient to mandate prophylactic endarterectomy.
Does not support routine prophylactic endarterectomy before general surgery; leaves open whether targeted preoperative evaluation improves outcomes.
The risk of stroke in unselected patients and patients with a carotid bruit undergoing general anesthesia and surgery is very low. The incremental risk related to known carotid stenosis is uncertain. The authors studied 284 patients with ultrasound studies before general surgery, 224 of whom demonstrated carotid stenosis. Carotid stenosis was related to a perioperative risk of stroke of approximately 3.6%. Greater degrees of stenosis did not confer significantly higher risk. Although higher than in the unselected population, this risk does not appear sufficient to mandate prophylactic endarterectomy.
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Evans et al. (2001) conducted an observational in Carotid stenosis before general surgery (n=284). Carotid stenosis vs. Unselected population was evaluated on Perioperative risk of stroke. Carotid stenosis detected before general surgery was associated with a perioperative stroke risk of approximately 3.6%, a risk insufficient to mandate prophylactic endarterectomy.
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