ASSESSMENT OF CAROTID ENDARTERECTOMY IN A SAMPLE OF IRANIAN PATIENTS

Abstract    BACKGROUND: Carotid endarterectomy (CEA) is recommended in patients with symptomatic and some times asymptomatic carotid stenosis in vascular surgery centers with low perioperative complication rate.    METHODS: A stenosis retrospective study was carried out in patients underwent CEA in ۳ vascular surgery centers in Tehran and ۲ centers in Mashhad. Patients’ selection criteria, methods of detection of carotid stenosis, method of anesthesia, surgical techniques and perioperative complications were evaluated.    RESULTS: Overall, ۳۸۸ CEA in ۳۴۵ patients (۶۵% males) with mean age of ۶۶.۸ year old (ranged ۴۶-۸۴ years) were evaluated. Detection of carotid stenosis was made by one carotid duplex ultrasound in ۹۰% of CEA candidates. The whole perioperative stroke death rate in reported Iranian vascular surgery centers is ۶.۴%. Perioperative stroke death rate in Imam Reza, Razavi, Shohaday Tajrish, Taleghani and Iranmehr hospitals was ۲.۴, ۰, ۴.۸, ,۱۰.۲ and ۱۰.۲ percent, respectively.    CONCLUSION: In Iran, CEA is recommended only in patients with symptomatic ≥ ۷۰% internal carotid arterystenosis and preferably in patients with symptomatic ≥ ۹۰% stenosis. Method of detection of carotid stenosis in Iranian vascular surgery centers should be corrected.      Keywords: Carotid, Endarterectomy, Iran.