Review of Carotid Endarterectomy at Singapore General Hospital

K Kumar, KK Tang, J Thomas, C Chumpon
Correspondence: Dr J Thomas, gnsjoh@sgh.com.sg

ABSTRACT
Aim To review the outcome of a consecutive series of patients undergoing carotid endarterectomy in a low volume setting.
Design Retrospective case review.
Patients During an 11-year period we performed 50 elective carotid endarterectomies on patients with symptomatic severe carotid stenosis: Ages of patients raised from 40 to 87 years (mean 68 years), 88% were Chinese, 6% Malay and 4% Indian. Twenty-eight percent had coronary artery disease, 64% hypertension, 27% diabetes mellitus, 50% hyperlipidaemia, and 52% were smokers. None of the patients had prior neck surgery or radiotherapy.
Results There were no deaths in this series of 50 cases. Ninety-eight percent of our patients came through surgery without major neurologic deficit. One patient (2%) suffered a major perioperative stroke. Minor neurologic sequelae included one patient (2%) with a mild non-disabling stroke, two patients (4%) with peri-operative TIA without significant sequelae; two patients (4%) with transient cranial nerve weakness (one vagus, one facial nerve).
Conclusion The surgical outcomes in this series are comparable to that from larger series. Carotid endarterectomy can be safely done in a low volume setting.

Keywords: carotid endarterectomy, low volume
Singapore Med J 2002; 43(12): 628-631