- Beebe H.G.
- Clagett G.P.
- DeWeese J.A.
- Moore W.S.
- Robertson J.T.
- Sandok B.
- et al.
- 1)Studies were identified from Medline and Embase with ‘carotid endarterectomy’ as the search term. Animal studies, studies with results of carotid surgery for non-atherosclerotic disease and review articles with no original data were excluded by reading the titles or the abstract and full paper where necessary. The reviewer then searched the resulting list of references for any reports that might contain relevant information. These were then pooled, and the process was repeated, using either the abstract and/or the full report to establish relevance (Fig. 1).
- 2)The bibliographies of all papers identified electronically were also searched.
- 3)The six journals with the largest number of relevant papers were searched manually for the period 2000–2008 (Fig. 1).
- 1)The numbers of combined strokes and deaths occurring within 30 days of CEA (or a similar time period) were reported.
- 2)The risks of stroke and/or death were defined, or able to be calculated, per operation.
- 3)Operative risks were reported by clinical indication. As a minimum, operative risks for symptomatic and asymptomatic stenosis were reported separately.
- 4)Patients with bilateral simultaneous endarterectomy were excluded, or data were reported separately so that they could be excluded from the analysis.
- 5)Patients with synchronous endarterectomy and coronary artery bypass grafting were excluded, or data were reported separately so that they could be excluded from the analysis.
Extraction of data
|Neurologist or Physician||Surgeon only|
|N||Stroke and death (95% CI)||Death (95% CI)||N||Stroke and death (95% CI)||Death (95% CI)|
|Pre 1980||4||18.3 (12.2–24.4)||6 (2.1–11.2)||3||4.7 (2.4–7.0)||3.1 (0.8–5.4)|
|1980–1984||7||13.2 (7.6–18.8)||4.3 (0.0–8.8)||9||4.1 (2.9–5.3)||1.6 (0.9–2.3)|
|1985–1989||3||6.4 (4.6–8.2)||5 (1.4–1.7)||14||5.0 (4.0–6.0)||1.4 (1.1–1.7)|
|1990–1993||6||6.5 (5.4–7.6)||2.9 (0.3–5.5)||12||4.6 (3.6–5.6)||1.9 (1.3–2.4)|
|1994–2000||11||6.5 (4.3–8.7)||1.6 (1.3–2.0)||34||4.2 (3.5–4.9)||1.4 (1.2–1.6)|
|2001–2008||21||5.6 (5.1–6.2)||1.5 (1.3–1.7)||25||3.9 (3.4–4.3)||1.1 (0.7–1.6)|
- Beebe H.G.
- Clagett G.P.
- DeWeese J.A.
- Moore W.S.
- Robertson J.T.
- Sandok B.
- et al.
Conflict of Interest
- Reanalysis of the final results of the European Carotid Surgery Trial.Stroke. 2003; 34: 514-523
- Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.N Engl J Med. 1998; 339: 1415-1425
- Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis.Lancet. 2003; 361: 107-116
- Regional performance of carotid endarterectomy. Appropriateness, outcomes, and risk factors for complications.Stroke. 1997; 28: 891-898
- Reducing the risk of carotid surgery: a 7-year audit of the role of monitoring and quality control assessment.J Vasc Surg. 2000; 32: 750-759
- Are we still performing inappropriate carotid endarterectomy?.Eur J Vasc Endovasc Surg. 2000; 20: 158-162
- A systematic comparison of the risks of stroke and death due to carotid endarterectomy for symptomatic and asymptomatic stenosis.Stroke. 1996; 27: 266-269
- A systematic review of the risks of stroke and death due to endarterectomy for symptomatic carotid stenosis.Stroke. 1996; 27: 260-265
- Relationship between provider volume and mortality for carotid endarterectomies in New York state.Stroke. 1998; 29: 2292-2297
- Indications, outcomes, and provider volumes for carotid endarterectomy.JAMA. 1998; 279: 1282-1287
- Is self-audit reliable?.Lancet. 1995; 346: 1623
- Assessing risk associated with carotid endarterectomy. A statement for health professionals by an ad hoc Committee on Carotid Surgery Standards of the Stroke Council, American Heart Association.Circulation. 1989; 79: 472-473
- Guidelines for carotid endarterectomy. A multidisciplinary consensus statement from the ad hoc Committee, American Heart Association.Stroke. 1995; 26: 188-201
- Time trends in the published risks of stroke and death due to endarterectomy for symptomatic carotid stenosis.Cerebrovasc Dis. 2004; 18: 37-46
- Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.N Engl J Med. 1991; 325: 445-453
- interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. European Carotid Surgery Trialists' Collaborative Group.Lancet. 1991; 337: 1235-1243
- Generalized linear models.Chapman and Hall, London1989
- Results of a multicenter prospective randomized trial of carotid artery stenting vs. carotid endarterectomy.Stroke. 2001; 32: 325
- Carotid angioplasty and stenting versus carotid endarterectomy: randomized trial in a community hospital.J Am Coll Cardiol. 2001; 38: 1589-1595
- Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis.N Engl J Med. 2006; 355: 1660-1671
- 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial.Lancet. 2006; 368: 1239-1247
- Carotid artery stenting versus carotid endarterectomy. A prospective randomised trial with long term follow up (BACASS).Schweiz Arch Neurol Psychiatr. 2006; 157: 191
- Early and late results of carotid endarterectomy: retrospective study of 70 operations.Sao Paulo Med J. 2001; 119: 206-211
- Carotid endarterectomy in women: challenging the results from ACAS and NASCET.Ann Surg. 2001; 234: 438-446
- Carotid endarterectomy results in the early years of practice.Surg Neurol. 2001; 56: 46-49
- High-risk carotid endarterectomy: challenges for carotid stent protocols.J Vasc Surg. 2002; 35: 16-21
- Outcomes of carotid endarterectomy: how does the Australian state of New South Wales compare with international benchmarks?.J Vasc Surg. 2002; 36 (Official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter): 62-69
- Surgical reconstruction of high grade carotid stenosis: a safe procedure?.Chirurgia. 2002; 73: 481-486
- Gender as a primary predictor of outcome after carotid endarterectomy.J Vasc Surg. 2002; 35: 748-753
- Perioperative result of carotid endarterectomies with venous patch angioplasty.Chinese Med J (Taipei). 2002; 65: 69-73
- Carotid endarterectomy then and now: outcome and cost-effectiveness of modern practice.Surgery. 2003; 134: 705-712
- Operative management of carotid artery stenosis.Journal fur Kardiologie. 2004; 11: 206-211
- Improvements in carotid endarterectomy in Scotland: results of a national prospective survey.Scott Med J. 2004; 49: 53-56
- Comparison between local and general anaesthesia for carotid endarterectomy. A retrospective analysis.Minerva Anestesiol. 2004; 70: 771-778
- Do vascular surgeons improve the outcome of carotid endarterectomy? An analysis of 12,618 elective cases in the state of Connecticut.Vascular. 2004; 12: 155-165
- Selective of treatment for patients with carotid artery disease: medication, carotid endarterectomy, or carotid artery stenting.Vascular. 2005; 12: 92-97
- Carotid endarterectomy remains the standard of care, even in high-risk surgical patients.Ann Surg. 2005; 241: 356-363
- Carotid endarterectomy without shunt: the role of cerebral metabolic protection.Neurol Res. 2005; 27: 850-856
- Does the high-risk patient for carotid endarterectomy really exist?.Am J Surg. 2005; 189: 714-719
- Outcomes of carotid endarterectomy for asymptomatic stenosis in Sweden are improving: results from a population-based registry.J Vasc Surg. 2006; 44: 79-85
- Early carotid endarterectomy in symptomatic patients is associated with poorer perioperative outcomes.J Vasc Surg. 2006; 44: 480-487
- Defining the high-risk patient for carotid endarterectomy: an analysis of the prospective National Surgical Quality Improvement Program database.J Vasc Surg. 2006; 43: 285-295
- Carotid endarterectomy in patients with acute neurological symptoms: a case-control study.Interact Cardiovasc Thorac Surg. 2007; 6: 369-373
- Long-term results of 442 consecutive, standardized carotid endarterectomy procedures in standard-risk and high-risk patients.J Vasc Surg. 2007; 46: 876-882
- The value of urgent carotid surgery for crescendo transient ischemic attacks.J Vasc Surg. 2007; 45: 1148-1154
- Mortality and morbidity of consecutive surgical carotid revascularisations in octogenarians.J Mal Vasc. 2007; 32: 192-200
- Comparison between early and late carotid endarterectomy for symptomatic carotid stenosis in relation to oxidized low-density lipoprotein and plaque vulnerability.J Vasc Surg. 2007; 46: 870-875
- Carotid endarterectomy within 2 weeks of minor ischemic stroke: a prospective study.J Vasc Surg. 2008;
- Urgent carotid endarterectomy is safe in patients with few comorbid medical conditions.Ann Vasc Surg. 2008; 22: 505-512
- Carotid reconstruction in nonagenarians: is surgery a viable option?.Ann Vasc Surg. 2008; 22: 190-194
- Modification of outcomes by lowering ischemic events after reconstruction of extracranial vessels (MOLIERE): an internet-based prospective study to evaluate and improve the effectiveness of carotid endarterectomy.J Vasc Surg. 2008; 47: 530-536
- Carotid endarterectomy. Experiences with shortening of interval between symptom and operation.Ugeskr Laeger. 2008; 170: 125-127
- Are adverse events after carotid endarterectomy reported comparable in different registries?.Eur J Vasc Endovasc Surg. 2008; 35: 280-285
- Is diabetes mellitus a risk factor for carotid endarterectomy? A prospective study.Surgery. 2001; 129: 146-152
- Racial variations in postoperative outcomes of carotid endarterectomy: evidence from the Veterans Affairs National Surgical Quality Improvement Program.Med Care. 2002; 40: I35-I43
- Revisiting the appropriateness of carotid endarterectomy.Stroke. 2003; 34: 1464-1471
- Emergency and early carotid endarterectomy in patients with acute ischemic stroke selected with a predefined protocol. A prospective pilot study.Int Angiol. 2003; 22: 426-430
- Risk factors for death or stroke after carotid endarterectomy: observations from the Ontario carotid endarterectomy registry.Stroke. 2003; 34: 2568-2573
- Multistate improvement in process and outcomes of carotid endarterectomy.J Vasc Surg. 2004; 39: 372-380
- Early carotid endarterectomy after acute stroke.J Vasc Surg. 2004; 39: 148-154
- Clinical and operative predictors of outcomes of carotid endarterectomy.J Vasc Surg. 2005; 42: 420-428
- Statins are associated with better outcomes after carotid endarterectomy in symptomatic patients.Stroke. 2005; 36: 2072-2076
- Predicting medical and surgical complications of carotid endarterectomy: comparing the risk indexes.Arch InternMed. 2006; 166: 914-920
- American society of anesthesiology and Rankin as predictive parameters for the outcome of carotid endarterectomy within 28 days after an ischemic stroke.J Stroke Cerebrovasc Dis. 2006; 15: 114-120
- Immediate CEA for symptomatic carotid disease preferably performed under local anaesthesia is safe.Vasa. 2007; 36: 185-190
- Carotid endarterectomy in the UK: acceptable risks but unacceptable delays.Clin Med. 2007; 7: 589-592
- Risk factors for perioperative death and stroke after carotid endarterectomy: results of the New York Carotid Surgery Study.Stroke. 2009; 40: 221-229
- Prospective randomized study of carotid endarterectomy with Fluoropassiv thin wall carotid patch versus venous patch.Eur J Vasc Endovasc Surg. 2008; 36: 45-52
- Clinical and angiographic risk factors for stroke and death within 30 days after carotid endarterectomy and stent-protected angioplasty: a subanalysis of the SPACE study.Lancet Neurol. 2008; 7: 216-222
- Interpretation of operative risks of individual surgeons. European Carotid Surgery Trialists' Collaborative Group.Lancet. 1999; 353: 1325
- Guidelines for carotid endarterectomy: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association.Stroke. 1998; 29: 554-562
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