• Vascular Annual Meeting
• General Information
• Call for Abstracts
• Exhibitor Information
• Future Meeting Dates
• Past Meeting Information
• Contact Us

PVSS4. Association Between Minor And Major Surgical Complications After Carotid Endarterectomy: Results Of The New York Carotid Artery Surgery Study

Alexander J. Greenstein, Mark R. Chassin, Jason Wang, Caron B. Rockman, Thomas S. Riles, Ethan A. Halm. Mount Sinai School of Medicine, New York, N.Y.

OBJECTIVES: Most studies on outcomes of carotid endarterectomy (CEA) have focused on the major complications of death and stroke. Less is known about minor surgical complications such as hematoma, cranial nerve (CN) palsy and wound infection. This study used data from a large, population-based study to describe the incidence of minor surgical complications following CEA and examine associations between minor and major complications.

METHODS:The New York Carotid Artery Surgery study examined all Medicare beneficiaries who underwent CEA from January 1998 to June 1999 in NY State. Detailed clinical information on preoperative characteristics and complications within 30 days of surgery was abstracted from hospital charts. Associations between minor complications (CN palsies, hematoma and wound infection) and major ones (death/stroke) were examined with chi square tests and multivariate logistic regression.

RESULTS: 9,308 CEAs were performed by 482 surgeons in 167 hospitals. Overall, 10% of patients had a minor surgical complication (CN palsy 5.5%, hematoma 5.0%, and wound infection 0.2%). In both unadjusted and adjusted analyses, the occurrence of any minor surgical complication, CN palsy alone, or hematoma alone was associated with 3 to 4-fold greater odds of perioperative stroke or combined risk of death and non-fatal stroke (p<0.0001).

CONCLUSIONS: Minor surgical complications are common after CEA and associated with much higher risk of death and stroke. Future work is needed to better understand the reason for these associations.