Carotid endarterectomy in a vascular fellowship training program: good results with a consistent technique.

OBJECTIVE: To find out whether carotid endarterectomy performed by senior residents or vascular fellows in a vascular fellowship program with a uniform technical approach can give results equal to or better than the acceptable standard. DESIGN: A case study with follow-up ranging from 121 to 1369 days. SETTING: A university teaching hospital. PATIENTS: Two hundred and one consecutive patients operated on between May 1989 and June 1993. INTERVENTIONS: Isolated carotid endarterectomy. MAIN OUTCOME MEASURES: Neurologic findings, cardiovascular complications and local wound problems after carotid endarterectomy. RESULTS: There were no deaths, one permanent stroke and two significant deficits from which the patients fully recovered. CONCLUSIONS: Carotid endarterectomy can be performed by senior surgical residents and vascular fellows within a vascular fellowship program, with a perioperative stroke and death rate of less than 1% when a uniform approach is used.