A Study of Preoperative Risk Factors and Postoperative Results in Patients Who Have Undergone Unilateral Carotid Endarterectomy

Abstract

Objective : In this study, the relationship between preoperative risk factors and operative outcomes in patients undergoing unilateral carotid endarterectomy was compared in the light of literature reviews. Material – Method : 223 patients who underwent unilateral carotid endarterectomy in Dr.Siyami Ersek Breast Heart and Vascular Surgery Training and Research Hospital in the years between 2007 and 2009 were included in the study. The mean age of the patients was 68.13 ± 5,25 and 29,5% of them were women (n=66) while 70,5% of them were men (n=157). 43.5% of patients (n=97) had hypertension and 61.2% of patients (n = 136) had diabetes mellitus. 76.1% of patients (n = 170) had a history of smoking while 29.3% of patients (n = 65) had hyperlipidemia. In 5.4% (n = 12) of patients experienced perioperative stroke, 10.8% (n = 24) of patients had a history of prolonged neurologic disease and 6.8% (n = 15) of patients had experienced transient ischemic attacks. Results : Patients undergoing carotid endarterectomy in the postoperative period were followed under 3 main headings: early neurologic complications, early cardiac arrhythmias and other complications (multiple organ failure, respiratory problems and hypertension). Early neurologic complications in patients were followed by the frequency of stroke, transient ischemic attack (TIA), and prolonged reversible ischemic neurological disease (PRIND). In this group, the rate of stroke patients in the postoperative period was 2.2% (n = 5) while the rate of TIA or PRIND patients was 4.1% (n = 9). Conclusion : Reducing mortality and morbidity after carotid artery endarterectomy is possible with a good analysis of preoperative risks and a good preoperative preparation. Cardiovascular surgeons have a great role and responsibility to reduce the risk and complications of carotid artery endarterectomy in preoperative, intraoperative and postoperative periods.