Carotid endarterectomy for severe asymptomatic carotid stenosis: a perioperative experience at a community hospital.

The purpose of this study was to evaluate the safety and feasibility of carotid endarterectomy (CEA) for severe asymptomatic carotid stenosis in a community setting with direct surgical resident participation. The medical records of all patients who had undergone CEA for severe asymptomatic carotid stenosis between 1989 and 1997 were retrospectively reviewed to ascertain perioperative morbidity and mortality. One hundred forty-seven CEAs were performed on 131 patients over the 8-year interval. Perioperative stroke and death rate was 0 per cent. However, one patient had a postoperative transient ischemic attack, and one patient had vocal cord dysfunction due to vagus nerve injury (1.3%). Three other patients had perioperative complications not directly related to CEA (2.1%). Therefore the total perioperative complication rate of (3.4%) compares favorably with results reported by several large tertiary referral centers. CEA for severe asymptomatic carotid stenosis can be safely performed in a community hospital setting with direct surgical resident participation.