Results and Future of Carotid Endarterectomy in a Medium-Sized Finnish Central Hospital

Background and Aims: Carotid endarterectomies (CEA) should, by general agreement, be performed only at specialised institutions and on patients who are expected to have a low rate of complications, i.e., a 6% surgical risk for patients with symptomatic and a 3% risk for patients with asymptomatic carotid artery disease. We have reviewed the midterm results after CEA in amedium-sized Finnish central hospital to audit whether our results fulfil current quality standards. Patients, Materials and Methods: There were 116 consecutively operated patients at the Päijät-Häme Central Hospital during the years 1999–2003 on whom 122 CEAs were made. All CEAs were performed by conventional methods and shunts and patches were used when necessary. Results: The overall survival rate was 81.0% during the 3.6 ± 1.5 years [range 1.3–6.3 years] follow-up. The incidence of early major stroke was 2.5% and of late major stroke 1.6%. Other complications included cranial nerve deficit (2.5%), wound haematoma (3.3%) and postoperative hypertension (3.3%) or hypotension (2.5%). Significant changes in medication were needed after surgery in several patient subgroups. Conclusions: The results of CEA at the Päijät-Häme Central Hospital are at least acceptable. The primary prevention of strokes with pharmacotherapy needs aggressive improvement.