Surgical treatment of carotid stenoses at a county hospital

BACKGROUND: High-degree stenosis of the internal carotid artery is a significant risk factor for cerebral infarction. It has been clearly demonstrated that endarterectomy reduces this risk if perioperative complications are maintained on a low level. MATERIAL AND METHODS: We studied the files of all patients undergoing carotid surgery in our hospital from 1985 through 2001. We also mailed questionnaires to all who were still alive in 2002. RESULTS: Over the period, 195 operations were performed on 168 patients (mean 12 operations per year). Their mean age was 63; 67% were men. In 30 cases (15%) the stenosis was asymptomatic. Within 30 days after surgery four patients had a disabling stroke, one had a retinal infarction and one patient died. The rate of perioperative stroke or death was 6.1%, while the rate for disabling stroke or death was 2.6%. Peripheral nerve injury, most often transitory, occurred in 5.7%. INTERPRETATION: The risk of moderate or serious perioperative complications is comparable to the multicentre studies that provide the rationale for the treatment (NASCET and ECST). Carotid endarterectomy in our hospital is safe in preventing stroke and should still be offered patients presenting to our centre.