ABSTRACT
Carotid endarterectomy (CE) is the most commonly performed vascular surgical procedure apart from coronary by-pass grafting (CABG) and the number of endarterectomies done in the United States has more than doubled in the past 6 years. In 1991, 66,000 CEs were recorded in the National Hospital Discharge Survey. This number rose to an estimated 144,000 in 1997 (R.Pokras, personal communication, 1999). In large Medicare population studies in the United States, perioperative mortality declined over a decade from 3% to half this figure (Karp et al., 1998; Hsia et al.) 1998). However, despite technical improvements, perioperative stroke and death, the conditions that this prophylactic operation is intended to prevent, continue to occur. The perioperative complication rate of stroke of any severity in expert centers remains in the range of 4%. Perioperative disabling stroke has declined but still remains at no less than 2.0% (Ferguson et al., 1999).
