Long-term outcomes of symptomatic and asymptomatic patients undergoing carotid endarterectomy in an average-volume community hospital

Acta Chir Belg. 2021 Dec;121(6):398-404. doi: 10.1080/00015458.2020.1798112. Epub 2020 Jul 25.

Abstract

Background: Long-term benefit of carotid endarectomy has not yet been fully investigated in average volume centers. Thus our purpose is to evaluate long-term results of carotid endarterectomies at a medium-volume hospital.

Methods: A retrospective analysis of carotid artery stenosis operated between 2008 and 2017 in a community hospital was done. Demographic and postoperative outcomes were evaluated in short and long-term by Kaplan-Meier survival analysis.

Results: 167 procedures in 159 patients were included. Average age was 72 years, and 65% were men. Twenty-nine percent of the patients were symptomatic and the rest asymptomatic. Median hospitalization was 3 (IQR 3-4) days and the mean follow-up was 56 months. No hospital mortality was recorded. At 120-month follow-up, freedom of stroke was 97.4%, death 97.3%, restenosis, 98.7% and all combined events 92.9% (log rank p = .042) Combined event-free survival was 84.4% in symptomatic patients, and 96.1% in asymptomatic patients (log rank p = .025).

Conclusions: In a medium-volume hospital combined event-free survival was 84.4% in symptomatic patients and 96.1% in asymptomatic at a 10-year follow-up.

Keywords: Carotid endarterectomy; free-survival; long term; stroke.

MeSH terms

  • Aged
  • Carotid Stenosis* / surgery
  • Endarterectomy, Carotid*
  • Hospitals, Community
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Stroke* / epidemiology
  • Stroke* / etiology
  • Time Factors
  • Treatment Outcome