Early and late outcomes in Hong Kong Chinese patients undergoing carotid endar terectomy

Objective To determine the benefit of carotid endarterectomy (CEA) for stroke prevention b y reviewing the early and late outcomes of Hong Kong Chinese patients undergoing CEA who have a high reported incidence of intracranial atherosclerotic disease (IAD).Methods Fifty-nine Chinese patients underwent 62 CEA. There were 48 males and 11 femal es, with a mean age of 70±7 years (range: 52-86 years). Twenty-one CEA (34%) were performed for asymptomatic disease. Duplex scan was the primary tool of ev aluation prior to surgery. Preoperative angiography was done in 36 instances ( 58%). All CEA were performed under general anaesthesia with routine intraoperat ive shunting. The arteriotomy was closed primarily in all patients except three . Patients were followed up regularly with six-monthly Duplex scan surveillanc e.Results There were 2 perioperative neurological events consisting of one transient ische mic attack and one minor stroke. There was no operative mortality or major morb idity such as bleeding or cranial nerve injury. Mean hospital stay was 6.5±4 days (range: 3-26 days). The patients were followed up for a mean interval of 2 4±17 months (range: 1-57 months). Seven patients died during follow-up and s ubsequent neurological events occurred in 5 patients, including 2 fatal strokes . The 3-year survival, freedom from stroke and stroke free survival were 86%, 87% and 83%, respectively. One recurrent stenosis of 80% was detected on follow -up Duplex scan.Conclusions Despite a high incidence of IAD, CEA in Hong Kong Chinese patients is associated with acceptable perioperative morbidity and mortality with satisfactory long-t erm efficacy in stroke prevention.