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. 2024 Apr;45(4):405-413.
doi: 10.15537/smj.2024.45.4.20230899.

Outcomes of carotid endarterectomy: Insights from a single-center retrospective cohort study

Sultan AlSheikh, Badr Aljabri, Tariq Alanezi  1 , Mussaad Al-Salman, Mohammed Y Aldossary  1 , Abdulatif H Almashat  1 , Hend S Elmutawi  1 , Rakan A Aldoghmani  1 , Talal Altuwaijri  1 , Kaisor Iqbal  1 , Abdulmajeed Altoijry
Affiliations

Outcomes of carotid endarterectomy: Insights from a single-center retrospective cohort study

Sultan AlSheikh et al. Saudi Med J. 2024 Apr.

Abstract

Objectives: To analyze the outcomes of carotid endarterectomy in individuals with carotid artery stenosis in the context of a tertiary care center.

Methods: We carried out a retrospective cohort investigation between 2015-2022. Patient data includes demographics, risk factors, preoperative medications, and operative details. The primary outcomes were 30-day postoperative stroke and mortality rates, while the secondary outcome of the study was to assess the morbidity of the procedure.

Results: The mean age of the 54 patients was 66.9±9.88 years, and 57.4% were men. The 30-day stroke rate was 3.7%, and the mortality rate was 1.9%. Most patients did not develop postoperative complications; however, surgical site hematoma was the most common complication encountered (12.9%). Long-term follow-up showed disease regression in 68.5% of patients, with a minority of patients developing ipsilateral restenosis. Admission to an intensive care monitoring unit was the only independent predictor of postoperative complications.

Conclusion: This study provided insights into the outcomes of carotid endarterectomy in patients with carotid artery stenosis, emphasizing the importance of careful patient selection and postoperative monitoring. Perioperative risks, including stroke and mortality, were within acceptable limits. Further research incorporating structured and non-structured data for predictive analyses, should explore refining patient profiling and optimizing treatment approaches for different carotid artery stenosis clinical and morphological presentations.

Keywords: antiplatelet therapy; carotid artery endarterectomy; carotid artery stenosis; stroke.

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Figures

Figure 1
Figure 1
- Patients risk factors. DM: diabetes mellitus, HTN: hypertension, DLP: dyslipidemia, IHD: ischemic heart disease, PAD: peripheral artery disease, CHF: congestive heart failure, Afib: atrial fibrillation, TIA: transient ischemic attack, CKD: chronic kidney disease, COPD: chronic obstructive pulmonary disease
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