Perioperative anticoagulation or antiplatelet therapy in cases of carotid endoarterectomy

Abstract

Objective To evaluate the efficacy and safety of perioperative anticoagulation and antiplatelet therapy of carotid endoarterectomy (CEA). Methods A retrospective study on 110 cases (122 CEAs) of carotid stenosis between Jan 2004 and Dec 2008 was undertaken. 122 cases were divided into anticoagulation group and antiplatelet group according to the perioperative medical treatment. Postoperative results of stroke/death and wound hemotoma were compared between the two groups and statistically analyzed. Results 45 CEAs were given perioperative combination of anticoagulation and antiplatelet treatment. This comprised the anticoagulation group. The antiplatelet group consisted of the other 77 CEAs which were treated with antiplatelet solely. Perioperative stroke/death rates were equivalent (2.2% anticoagulation vs. 2.6% antiplatelet, P =0.897). Wound hemotoma rates were found with statistical significant difference between the two groups (13.3% anticoagulation group vs. 1.3% antiplatelet group, P = 0. 006 ). Conclusion Our results suggest that perioperative antiplatelet therapy in perioperative carotid endoarterectomy does not increase perioperative stroke/death risk, while perioperative anticoagulation increases the risk of wound hematoma. Key words: Endarterectomy,carotid; Anticoagulants; Platelet aggregation inhibitors; Hematoma