A study of carotid endarterectomy in a Chinese population: initial experience at a single center

Abstract

Objective: This retrospective study aimed to evaluate our initial experience with carotid endarterectomy in a Chinese population.

Methods: Four hundred and thirty-three patients who underwent carotid endarterectomies at Xuan Wu Hospital Capital Medical University between January 1, 2001, and December 31, 2012, were reviewed. The postoperative 30-day complications were analyzed. Univariate and multivariate logistic regression analyses were used to analyze the factors associated with perioperative stroke and death.

Results: The overall 30-day complication rates after surgery were 4.08% for death and stroke, 3.63% for cranial nerve injuries, and 3.63% for heart complications. The mean follow-up time was 32.99 months, and only 11 cases required restenosis, including two that were symptomatic (experiencing transient ischemic attacks). In the univariate analysis, a history of cerebral infarction was present preoperatively in 179 patients, of whom 12 (6.70%) had a postoperative stroke or died (P=0.021). Thirty-two patients had a modified Ranking score (mRS)≥ 3, and six (18.75%) of these patients had a postoperative stroke or died (P<0.001). In the multivariate logistic regression, female gender (OR: 4.669; 95% CI: 1.238-17.602; P=0.023), current smoking habits (OR: 3.826; 95% CI: 1.298-11.277; P=0.015), and an mRS ≥ 3 (OR: 1.540; 95% CI: 3.844-40.909; P<0.001) were independent risk factors for perioperative stroke and death.

Conclusions: In our single-center study, carotid endarterectomies appeared to effectively prevent and treat the carotid artery stenosis that leads to stroke. Female gender, current smoking habits, and neurological deficits (mRS ≥ 3) increased the perioperative stroke and death rates.

Keywords: Carotid endarterectomy; Carotid stenosis; Chinese population.