Short Term Outcomes of Endarterectomy to Asymptomatic Extracranial Carotid Artery Disease

Abstract

Aim: Recently published papers regarding the treatment of carotid artery stenosis are in contradiction with previous trials. Some experts have argued that this evidence supports a conservative approach to carotid revascularization (carotid endarterectomy or carotid stenting) in asymptomatic patients. The objective of this study is to evaluate outcomes of carotid endarterectomy based on preoperative symptom status.Material and Methods: This retrospective study included patients underwent carotid endarterectomy to internal carotid artery between August 2008 and August 2015. Patients were divided into two groups according to preoperative symptoms. Asymptomatic group consisted of 41 patients with no preoperative neurological symptoms, and symptomatic group of 62 patients with preoperative neurological symptoms (vertigo, amaurosis fugax, transient ischemic attack and ischemic stroke). Postoperatively, all patients received standard therapy in line with the recommendation of the guidelines.Results: One hundred and three patients were enrolled in this study. The mean age of patients was 68.20±9.79 (range, 41-86) years, and 27 (26.2%) of them were female. There were no statistically significant difference in terms of demographic characteristics between the groups except risk groups; asymptomatic group had more high risk grouped patients (p=0.001). Asymptomatic group was associated with statistically significantly more postoperative mortality compared with symptomatic group (p=0.028). None of the preoperative variables were related to postoperative stroke. In symptomatic group, postoperative stroke was seen in the patients who had preoperative transient ischemic attack and major stroke.Conclusion: Time of surgical treatment in asymptomatic carotid artery disease should be planned according to patients’ cardiac risk factors.