Long-term prognosis after carotid endarterectomy.

Abstract

This study analyzed 76 consecutive patients with carotid transient ischemic attacks (TIA) and carotid lesions appropriate to symptoms who underwent endarterectomy during the period 1975-1981. The mean age of the patients was 51.9 +/- 8 years at the time of surgery. Hypertension was present in 32.9%, diabetes mellitus in 13%, ischemic cardiopathy in 8.2% and peripheral vascular disease in 6.6%. Operative mortality was 1.3% and harder morbidity 4%. The average follow-up was 2.6 years (range 1-7 years). The observed 5-year survival rate was 85.2% compared to the expected rate of 92.4% in a normal population. During the follow-up 5 patients had a stroke: the cumulative stroke rate was 4.6% at 1 year and 7.9% at 3 years. 18 patients had further TIAs (13 carotid TIAs and 5 vertebro-basilar TIAs). 6 patients suffered myocardial infarction. The prognosis of TIA patients treated with endarterectomy is difficult to evaluate because the natural history of TIAs is still undefined.