Key result
Carotid endarterectomy during 1985-1991 is linked to ~90% lower perioperative stroke or death versus 1965-1984.
Why the study?
Complications from carotid endarterectomy in patients with ICA stenosis and contralateral occlusion remain a concern, with prior reports indicating high perioperative stroke or death risk.
Does the era of surgery and improved techniques reduce perioperative stroke or death in patients undergoing carotid endarterectomy with contralateral occlusion?
Population
315 patients with occlusion of one ICA undergoing contralateral carotid endarterectomy
Comparison
Carotid endarterectomy 1985-1991 (Group B) vs 1965-1984 (Group A)
Design
Cohort study
Follow-up
Perioperative
Authors
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Supports refined risk estimates for high-risk CEA; extends Level 3 evidence but leaves practice implications to prospective study.
Cohort (n=315)
Does the era of surgery and improved techniques reduce perioperative stroke or death in patients undergoing carotid endarterectomy with contralateral occlusion?
Absolute Event Rate: 0.7% vs 6.7%
p-value: p=<0.01
Improved patient selection and surgical techniques over time have significantly reduced the perioperative stroke or death rate in patients undergoing carotid endarterectomy with contralateral occlusion.
Adelman et al. (1995) conducted a cohort in Internal carotid artery stenosis with contralateral occlusion (n=315). Carotid endarterectomy (1985-1991 era) vs. Carotid endarterectomy (1965-1984 era) was evaluated on Combined perioperative stroke or death (p=<0.01). Carotid endarterectomy for ICA stenosis with contralateral occlusion between 1985-1991 yielded a lower perioperative stroke or death rate than between 1965-1984 (0.7% vs 6.7%, P<0.01).
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