Influence of patient-related variables on the outcome of carotid endarterectomy

Abstract

Presenting symptoms significantly predict outcome after carotid endarterectomy. This should be considered both in patient selection and comparison of patient series.

Systematic Review of the Risks of Carotid Endarterectomy in Relation to the Clinical Indication for and Timing of Surgery

“…The low operative risk of stroke in patients with ocular ischemic events is consistent with the similarly low risk of stroke in those on medical treatment. 10,[25][26][27] The explanation for this good prognosis in patients with ocular ischemic events is uncertain, and evidence of particularly good collateral circulation toward the ipsilateral cerebral hemisphere is conflicting. [27][28][29] Many reports of the operative risk of CEA include a category of symptomatic indications that are generally called nonhemispheric.…”

“…Some studies have reported very high operative risks for urgent CEA for evolving symptoms, 10,11 whereas others have suggested that the risk is similar to that for stable symptoms. 12 However, the numbers of patients within individual studies are far too small to draw reliable conclusions.…”

Osteoprotegerin and Osteopontin Are Expressed at High Concentrations Within Symptomatic Carotid Atherosclerosis

“…Patients included in the study either presented with focal neurological symptoms related to their anterior cerebral circulation (transient ischemic attack, amaurosis fugax, and stroke) within 6 weeks of surgery (defined as symptomatic) or presented with no history of neurological symptoms (defined as asymptomatic). 22 Patients with nonfocal, atypical, or distant neurological symptoms were excluded. Patients receiving angiotensin-converting enzyme inhibitors or angiotensin II blockers were excluded.…”

Systematic Comparison of the Early Outcome of Angioplasty and Endarterectomy for Symptomatic Carotid Artery Disease

“…34 Two of the angioplasty studies and 2 of the endarterectomy series did not separate patients presenting with TIA and stroke. 12,21,27,28 Excluding these studies, 58% of patients treated by angioplasty compared with 70% of patients undergoing endarterectomy presented with a TIA (Tables 1 and 3; 2 ϭ8.49, PϽ0.01).…”