Factors Associated with Perioperative Complications during Carotid Endarterectomy

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Abstract
Records from 166 cases of unilateral carotid endarterectomy were reviewed to investigate the association of certain preoperative and intraoperative factors with perioperative complications including hypertension and hypotension, neurologic deficit, myocardial infarction, and mortality. No myocardial infarctions occurred and mortality was zero. Complications associated with some of the study factors included postoperative hypertension and neurologic deficit. Postoperative hypertension occurred more frequently (a) in patients with poor preoperative blood pressure (BP) control (BP ≥ 170/95 torr) than in those with adequate control (BP < 170/95 torr) or normotension (52%. 35%, and 17%, respectively, p < 0.01 and, (b) when additional peripheral vascular disease was present (43% vs 25%. p < 0.05). The incidence of neurologic deficit was higher when hypertension developed after surgery (20%) than when patients remained normotensive (6%) or developed hypotension (0%, p < 0.05). Patients whose hypertension was poorly controlled had a greater incidence of transient neurologic deficit (23.8%) than patients with controlled hypertension (2.5%) or patients with normotension (1.5%, p < 0.01); permanent neurologic deficit occurred more frequently in those with bilateral disease on angiography than in those with unilateral disease (8.8% vs 1.2%, p < 0.05).

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