Risk factors associated with carotid endarterectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Zuoguan ,  LI Yongjun

Department of Vascular Surgery, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, P. R. China;

Corresponding author：

LI Yongjun, Email: liyongjun4679@bjhmoh.cn

Keywords：

carotid artery stenosis; carotid endarterectomy; risk factor; predict model; review

DOI：

10.7507/1007-9424.202009036

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the risk factors of carotid endarterectomy.Method The literatures about carotid artery stenosis in the past 30 years were screened through literature retrieval, and the study of surgical risk factors related to carotid artery stenosis were reviewed.Results There were many risk factors associated with the carotid endarterectomy, including demographic, underlying disease, surgical factors, perioperative management, and so on. However, the risk factors analysis were not comprehensive enough in the current study, so there was still lack of effective methods to predict the surgical risk of carotid artery stenosis.Conclusion To fully understand the risk factors of carotid endarterectomy and to establish a multi-factor prediction model is the direction of further research.

Citation： CHEN Zuoguan, LI Yongjun. Risk factors associated with carotid endarterectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(6): 831-836. doi: 10.7507/1007-9424.202009036 Copy

1.	North American Symptomatic Carotid Endarterectomy Trial Collaborators; Barnett HJM, Taylor DW, et al. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med, 1991, 325(7): 445-453.
2.	Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA, 1995, 273(18): 1421-1428.
3.	Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J, 2018, 39(9): 763-816.
4.	Nguyen LL, Conte MS, Reed AB, et al. Carotid endarterectomy: who is the high-risk patient? Semin Vasc Surg, 2004, 17(3): 219-223.
5.	Oliveira PP, Vieira JLDC, Guimarães RB, et al. Risk-benefit assessment of carotid revascularization. Arq Bras Cardiol, 2018, 111(4): 618-625.
6.	韩伟, 符伟国, 王玉琦, 等. 高危颈动脉狭窄患者的外科治疗 (附24例报告). 中国普外基础与临床杂志, 2004, 11(4): 304-306.
7.	刁永鹏, 刘昌伟, 宋小军, 等. 颈动脉内膜剥脱术治疗高龄颈动脉狭窄患者的安全性和有效性分析. 中国普外基础与临床杂志, 2014, 21(1): 60-64.
8.	Keyhani S, Madden E, Cheng EM, et al. Risk prediction tools to improve patient selection for carotid endarterectomy among patients with asymptomatic carotid stenosis. JAMA Surg, 2019, 154(4): 336-344.
9.	Varghese R, Norman P. Carotid endarterectomy in octogenarians. ANZ J Surg, 2004, 74(4): 215-217.
10.	Saleh SS, Hannan EL. Carotid endarterectomy utilization and mortality in 10 states. Am J Surg, 2004, 187(1): 14-19.
11.	Bond R, Rerkasem K, Cuffe R, et al. A systematic review of the associations between age and sex and the operative risks of carotid endarterectomy. Cerebrovasc Dis, 2005, 20(2): 69-77.
12.	Ballotta E, Renon L, Da Giau G, et al. Octogenarians with contralateral carotid artery occlusion: a cohort at higher risk for carotid endarterectomy? J Vasc Surg, 2004, 39(5): 1003-1008.
13.	Miller MT, Comerota AJ, Tzilinis A, et al. Carotid endarterectomy in octogenarians: does increased age indicate “high risk?”. J Vasc Surg, 2005, 41(2): 231-237.
14.	Sadideen H, Thomson DR, Lewis RR, et al. Carotid endarterectomy in the elderly: risk factors, intraoperative carotid hemodynamics and short-term complications: a UK tertiary center retrospective analysis. Vascular, 2013, 21(5): 273-277.
15.	Kapral MK, Wang H, Austin PC, et al. Sex differences in carotid endarterectomy outcomes: results from the Ontario Carotid Endarterectomy Registry. Stroke, 2003, 34(5): 1120-1125.
16.	Harthun NL, Kongable GL, Baglioni AJ, et al. Examination of sex as an independent risk factor for adverse events after carotid endarterectomy. J Vasc Surg, 2005, 41(2): 223-230.
17.	Stelągowski M, Kasielska-Trojan A, Bogusiak K, et al. Gender-related risk factors for perioperative stroke after carotid endarterectomy in symptomatic patients. Adv Clin Exp Med, 2017, 26(8): 1225-1231.
18.	Dardik A, Bowman HM, Gordon TA, et al. Impact of race on the outcome of carotid endarterectomy: a population-based analysis of 9, 842 recent elective procedures. Ann Surg, 2000, 232(5): 704-709.
19.	Tu JV, Wang H, Bowyer B, et al. Risk factors for death or stroke after carotid endarterectomy: observations from the Ontario Carotid Endarterectomy Registry. Stroke, 2003, 34(11): 2568-2573.
20.	McGirt MJ, Perler BA, Brooke BS, et al. 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors reduce the risk of perioperative stroke and mortality after carotid endarterectomy. J Vasc Surg, 2005, 42(5): 829-837.
21.	Harthun NL, Stukenborg GJ. Atrial fibrillation is associated with increased risk of perioperative stroke and death from carotid endarterectomy. J Vasc Surg, 2010, 51(2): 330-336.
22.	Rong X, Yang W, Garzon-Muvdi T, et al. Risk factors associated with ipsilateral ischemic events following carotid endarterectomy for carotid artery stenosis. World Neurosurg, 2016, 89: 611-619.
23.	Akbari CM, Pomposelli FB Jr, Gibbons GW, et al. Diabetes mellitus: a risk factor for carotid endarterectomy? J Vasc Surg, 1997, 25(6): 1070-1076.
24.	Patel AR, Dombrovskiy VY, Vogel TR. A contemporary evaluation of carotid endarterectomy outcomes in patients with chronic kidney disease in the United States. Vascular, 2017, 25(5): 459-465.
25.	Reed AB, Gaccione P, Belkin M, et al. Preoperative risk factors for carotid endarterectomy: defining the patient at high risk. J Vasc Surg, 2003, 37(6): 1191-1199.
26.	Kragsterman B, Logason K, Ahari A, et al. Risk factors for complications after carotid endarterectomy–a population-based study. Eur J Vasc Endovasc Surg, 2004, 28(1): 98-103.
27.	Antoniou GA, Kuhan G, Sfyroeras GS, et al. Contralateral occlusion of the internal carotid artery increases the risk of patients undergoing carotid endarterectomy. J Vasc Surg, 2013, 57(4): 1134-1145.
28.	Cheng W, Lu H, Hu Y. Influence of contralateral carotid occlusion on outcomes after carotid endarterectomy: a meta-analysis. J Stroke Cerebrovasc Dis, 2018, 27(10): 2587-2595.
29.	Hill BB, Olcott C 4th, Dalman RL, et al. Reoperation for carotid stenosis is as safe as primary carotid endarterectomy. J Vasc Surg, 1999, 30(1): 26-35.
30.	Harris RA, Stow N, Fisher CM, et al. Carotid redo surgery: both safe and durable. ANZ J Surg, 2003, 73(12): 1000-1003.
31.	Cho JS, Pandurangi K, Conrad MF, et al. Safety and durability of redo carotid operation: an 11-year experience. J Vasc Surg, 2004, 39(1): 155-161.
32.	Kondo T, Ota N, Göhre F, et al. High cervical carotid endarterectomy-outcome analysis. World Neurosurg, 2020, 136: e108-e118.
33.	Strömberg S, Gelin J, Osterberg T, et al. Very urgent carotid endarterectomy confers increased procedural risk. Stroke, 2012, 43(5): 1331-1335.
34.	Kfoury E, Dort J, Trickey A, et al. Carotid endarterectomy under local and/or regional anesthesia has less risk of myocardial infarction compared to general anesthesia: an analysis of national surgical quality improvement program database. Vascular, 2015, 23(2): 113-119.
35.	Ben Ahmed S, Daniel G, Benezit M, et al. Does the technique of carotid endarterectomy determine postoperative hypertension? Ann Vasc Surg, 2015, 29(6): 1272-1280.
36.	Chen GZ, Wu YZ, Diao PY, et al. Comparison of eversion carotid endarterectomy and patch carotid endarterectomy: a retrospective study of 6 years of experience. Med Sci Monit, 2018, 24: 5820-5825.
37.	Aziz F, Lehman EB, Reed AB. Increased duration of operating time for carotid endarterectomy is associated with increased mortality. Ann Vasc Surg, 2016, 36: 166-174.
38.	Levin SR, Farber A, Goodney PP, et al. Shunt intention during carotid endarterectomy in the early symptomatic period and perioperative stroke risk. J Vasc Surg, 2020, 72(4): 1385-1394.
39.	Gansera B, Angelis I, Weingartner J, et al. Simultaneous carotid endarterectomy and cardiac surgery–additional risk factor or safety procedure? Thorac Cardiovasc Surg, 2003, 51(1): 22-27.
40.	Borger MA, Fremes SE, Weisel RD, et al. Coronary bypass and carotid endarterectomy: does a combined approach increase risk? A meta analysis. Ann Thorac Surg, 1999, 68(1): 14-20, 21.
41.	Wang LJ, Ergul EA, Conrad MF, et al. Addition of proximal intervention to carotid endarterectomy increases risk of stroke and death. J Vasc Surg, 2019, 69(4): 1102-1110.
42.	de Waard DD, de Borst GJ, Bulbulia R, et al. Diastolic blood pressure is a risk factor for peri-procedural stroke following carotid endarterectomy in asymptomatic patients. Eur J Vasc Endovasc Surg, 2017, 53(5): 626-631.
43.	Lepore MR Jr, Sternbergh WC 3rd, Salartash K, et al. Influence of NASCET/ACAS trial eligibility on outcome after carotid endarterectomy. J Vasc Surg, 2001, 34(4): 581-586.
44.	Gasparis AP, Ricotta L, Cuadra SA, et al. High-risk carotid endarterectomy: fact or fiction. J Vasc Surg, 2003, 37(1): 40-46.
45.	Ballotta E, Da Giau G, Baracchini C, et al. Carotid endarterectomy in high-risk patients: a challenge for endovascular procedure protocols. Surgery, 2004, 135(1): 74-80.
46.	Halm EA, Tuhrim S, Wang JJ, et al. Risk factors for perioperative death and stroke after carotid endarterectomy: results of the new york carotid artery surgery study. Stroke, 2009, 40(1): 221-229.
47.	Bekelis K, Bakhoum SF, Desai A, et al. A risk factor-based predictive model of outcomes in carotid endarterectomy: the National Surgical Quality Improvement Program 2005-2010. Stroke, 2013, 44(4): 1085-1090.
48.	陈作观, 李拥军, 刁永鹏, 等. 颈动脉内膜剥脱术治疗颈动脉狭窄的疗效与危险因素分析. 中华医学杂志, 2017, 97(36): 2839-2843.
49.	Knappich C, Kuehnl A, Haller B, et al. Associations of perioperative variables with the 30-day risk of stroke or death in carotid endarterectomy for symptomatic carotid stenosis. Stroke, 2019, 50(12): 3439-3448.
50.	Radak D, de Waard D, Halliday A, et al. Carotid endarterectomy has significantly lower risk in the last two decades: should the guidelines now be updated? J Cardiovasc Surg (Torino), 2018, 59(4): 586-599.
51.	Duschek N, Ghai S, Sejkic F, et al. Homocysteine improves risk stratification in patients undergoing endarterectomy for asymptomatic internal carotid artery stenosis. Stroke, 2013, 44(8): 2311-2314.
52.	Edsfeldt A, Bengtsson E, Asciutto G, et al. High plasma levels of galectin-3 are associated with increased risk for stroke after carotid endarterectomy. Cerebrovasc Dis, 2016, 41(3-4): 199-203.

1. North American Symptomatic Carotid Endarterectomy Trial Collaborators; Barnett HJM, Taylor DW, et al. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med, 1991, 325(7): 445-453.
2. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA, 1995, 273(18): 1421-1428.
3. Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J, 2018, 39(9): 763-816.
4. Nguyen LL, Conte MS, Reed AB, et al. Carotid endarterectomy: who is the high-risk patient? Semin Vasc Surg, 2004, 17(3): 219-223.
5. Oliveira PP, Vieira JLDC, Guimarães RB, et al. Risk-benefit assessment of carotid revascularization. Arq Bras Cardiol, 2018, 111(4): 618-625.
6. 韩伟, 符伟国, 王玉琦, 等. 高危颈动脉狭窄患者的外科治疗 (附24例报告). 中国普外基础与临床杂志, 2004, 11(4): 304-306.
7. 刁永鹏, 刘昌伟, 宋小军, 等. 颈动脉内膜剥脱术治疗高龄颈动脉狭窄患者的安全性和有效性分析. 中国普外基础与临床杂志, 2014, 21(1): 60-64.
8. Keyhani S, Madden E, Cheng EM, et al. Risk prediction tools to improve patient selection for carotid endarterectomy among patients with asymptomatic carotid stenosis. JAMA Surg, 2019, 154(4): 336-344.
9. Varghese R, Norman P. Carotid endarterectomy in octogenarians. ANZ J Surg, 2004, 74(4): 215-217.
10. Saleh SS, Hannan EL. Carotid endarterectomy utilization and mortality in 10 states. Am J Surg, 2004, 187(1): 14-19.
11. Bond R, Rerkasem K, Cuffe R, et al. A systematic review of the associations between age and sex and the operative risks of carotid endarterectomy. Cerebrovasc Dis, 2005, 20(2): 69-77.
12. Ballotta E, Renon L, Da Giau G, et al. Octogenarians with contralateral carotid artery occlusion: a cohort at higher risk for carotid endarterectomy? J Vasc Surg, 2004, 39(5): 1003-1008.
13. Miller MT, Comerota AJ, Tzilinis A, et al. Carotid endarterectomy in octogenarians: does increased age indicate “high risk?”. J Vasc Surg, 2005, 41(2): 231-237.
14. Sadideen H, Thomson DR, Lewis RR, et al. Carotid endarterectomy in the elderly: risk factors, intraoperative carotid hemodynamics and short-term complications: a UK tertiary center retrospective analysis. Vascular, 2013, 21(5): 273-277.
15. Kapral MK, Wang H, Austin PC, et al. Sex differences in carotid endarterectomy outcomes: results from the Ontario Carotid Endarterectomy Registry. Stroke, 2003, 34(5): 1120-1125.
16. Harthun NL, Kongable GL, Baglioni AJ, et al. Examination of sex as an independent risk factor for adverse events after carotid endarterectomy. J Vasc Surg, 2005, 41(2): 223-230.
17. Stelągowski M, Kasielska-Trojan A, Bogusiak K, et al. Gender-related risk factors for perioperative stroke after carotid endarterectomy in symptomatic patients. Adv Clin Exp Med, 2017, 26(8): 1225-1231.
18. Dardik A, Bowman HM, Gordon TA, et al. Impact of race on the outcome of carotid endarterectomy: a population-based analysis of 9, 842 recent elective procedures. Ann Surg, 2000, 232(5): 704-709.
19. Tu JV, Wang H, Bowyer B, et al. Risk factors for death or stroke after carotid endarterectomy: observations from the Ontario Carotid Endarterectomy Registry. Stroke, 2003, 34(11): 2568-2573.
20. McGirt MJ, Perler BA, Brooke BS, et al. 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors reduce the risk of perioperative stroke and mortality after carotid endarterectomy. J Vasc Surg, 2005, 42(5): 829-837.
21. Harthun NL, Stukenborg GJ. Atrial fibrillation is associated with increased risk of perioperative stroke and death from carotid endarterectomy. J Vasc Surg, 2010, 51(2): 330-336.
22. Rong X, Yang W, Garzon-Muvdi T, et al. Risk factors associated with ipsilateral ischemic events following carotid endarterectomy for carotid artery stenosis. World Neurosurg, 2016, 89: 611-619.
23. Akbari CM, Pomposelli FB Jr, Gibbons GW, et al. Diabetes mellitus: a risk factor for carotid endarterectomy? J Vasc Surg, 1997, 25(6): 1070-1076.
24. Patel AR, Dombrovskiy VY, Vogel TR. A contemporary evaluation of carotid endarterectomy outcomes in patients with chronic kidney disease in the United States. Vascular, 2017, 25(5): 459-465.
25. Reed AB, Gaccione P, Belkin M, et al. Preoperative risk factors for carotid endarterectomy: defining the patient at high risk. J Vasc Surg, 2003, 37(6): 1191-1199.
26. Kragsterman B, Logason K, Ahari A, et al. Risk factors for complications after carotid endarterectomy–a population-based study. Eur J Vasc Endovasc Surg, 2004, 28(1): 98-103.
27. Antoniou GA, Kuhan G, Sfyroeras GS, et al. Contralateral occlusion of the internal carotid artery increases the risk of patients undergoing carotid endarterectomy. J Vasc Surg, 2013, 57(4): 1134-1145.
28. Cheng W, Lu H, Hu Y. Influence of contralateral carotid occlusion on outcomes after carotid endarterectomy: a meta-analysis. J Stroke Cerebrovasc Dis, 2018, 27(10): 2587-2595.
29. Hill BB, Olcott C 4th, Dalman RL, et al. Reoperation for carotid stenosis is as safe as primary carotid endarterectomy. J Vasc Surg, 1999, 30(1): 26-35.
30. Harris RA, Stow N, Fisher CM, et al. Carotid redo surgery: both safe and durable. ANZ J Surg, 2003, 73(12): 1000-1003.
31. Cho JS, Pandurangi K, Conrad MF, et al. Safety and durability of redo carotid operation: an 11-year experience. J Vasc Surg, 2004, 39(1): 155-161.
32. Kondo T, Ota N, Göhre F, et al. High cervical carotid endarterectomy-outcome analysis. World Neurosurg, 2020, 136: e108-e118.
33. Strömberg S, Gelin J, Osterberg T, et al. Very urgent carotid endarterectomy confers increased procedural risk. Stroke, 2012, 43(5): 1331-1335.
34. Kfoury E, Dort J, Trickey A, et al. Carotid endarterectomy under local and/or regional anesthesia has less risk of myocardial infarction compared to general anesthesia: an analysis of national surgical quality improvement program database. Vascular, 2015, 23(2): 113-119.
35. Ben Ahmed S, Daniel G, Benezit M, et al. Does the technique of carotid endarterectomy determine postoperative hypertension? Ann Vasc Surg, 2015, 29(6): 1272-1280.
36. Chen GZ, Wu YZ, Diao PY, et al. Comparison of eversion carotid endarterectomy and patch carotid endarterectomy: a retrospective study of 6 years of experience. Med Sci Monit, 2018, 24: 5820-5825.
37. Aziz F, Lehman EB, Reed AB. Increased duration of operating time for carotid endarterectomy is associated with increased mortality. Ann Vasc Surg, 2016, 36: 166-174.
38. Levin SR, Farber A, Goodney PP, et al. Shunt intention during carotid endarterectomy in the early symptomatic period and perioperative stroke risk. J Vasc Surg, 2020, 72(4): 1385-1394.
39. Gansera B, Angelis I, Weingartner J, et al. Simultaneous carotid endarterectomy and cardiac surgery–additional risk factor or safety procedure? Thorac Cardiovasc Surg, 2003, 51(1): 22-27.
40. Borger MA, Fremes SE, Weisel RD, et al. Coronary bypass and carotid endarterectomy: does a combined approach increase risk? A meta analysis. Ann Thorac Surg, 1999, 68(1): 14-20, 21.
41. Wang LJ, Ergul EA, Conrad MF, et al. Addition of proximal intervention to carotid endarterectomy increases risk of stroke and death. J Vasc Surg, 2019, 69(4): 1102-1110.
42. de Waard DD, de Borst GJ, Bulbulia R, et al. Diastolic blood pressure is a risk factor for peri-procedural stroke following carotid endarterectomy in asymptomatic patients. Eur J Vasc Endovasc Surg, 2017, 53(5): 626-631.
43. Lepore MR Jr, Sternbergh WC 3rd, Salartash K, et al. Influence of NASCET/ACAS trial eligibility on outcome after carotid endarterectomy. J Vasc Surg, 2001, 34(4): 581-586.
44. Gasparis AP, Ricotta L, Cuadra SA, et al. High-risk carotid endarterectomy: fact or fiction. J Vasc Surg, 2003, 37(1): 40-46.
45. Ballotta E, Da Giau G, Baracchini C, et al. Carotid endarterectomy in high-risk patients: a challenge for endovascular procedure protocols. Surgery, 2004, 135(1): 74-80.
46. Halm EA, Tuhrim S, Wang JJ, et al. Risk factors for perioperative death and stroke after carotid endarterectomy: results of the new york carotid artery surgery study. Stroke, 2009, 40(1): 221-229.
47. Bekelis K, Bakhoum SF, Desai A, et al. A risk factor-based predictive model of outcomes in carotid endarterectomy: the National Surgical Quality Improvement Program 2005-2010. Stroke, 2013, 44(4): 1085-1090.
48. 陈作观, 李拥军, 刁永鹏, 等. 颈动脉内膜剥脱术治疗颈动脉狭窄的疗效与危险因素分析. 中华医学杂志, 2017, 97(36): 2839-2843.
49. Knappich C, Kuehnl A, Haller B, et al. Associations of perioperative variables with the 30-day risk of stroke or death in carotid endarterectomy for symptomatic carotid stenosis. Stroke, 2019, 50(12): 3439-3448.
50. Radak D, de Waard D, Halliday A, et al. Carotid endarterectomy has significantly lower risk in the last two decades: should the guidelines now be updated? J Cardiovasc Surg (Torino), 2018, 59(4): 586-599.
51. Duschek N, Ghai S, Sejkic F, et al. Homocysteine improves risk stratification in patients undergoing endarterectomy for asymptomatic internal carotid artery stenosis. Stroke, 2013, 44(8): 2311-2314.
52. Edsfeldt A, Bengtsson E, Asciutto G, et al. High plasma levels of galectin-3 are associated with increased risk for stroke after carotid endarterectomy. Cerebrovasc Dis, 2016, 41(3-4): 199-203.

Previous Article
Advances of nucleosome in diagnosis and treatment of colorectal cancer
Next Article
Application and progress of mixed reality technology in vascular surgery

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Risk factors associated with carotid endarterectomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content