Carotid endarterectomy and the risk of perioperative stroke: The importance of chronic ischaemic lesions and small vessel disease
2025

Carotid Endarterectomy and Stroke Risk

Sample size: 488 publication 10 minutes Evidence: moderate

Author Information

Author(s): Henrietta Törmänen, Suvi Koskinen, Krista Nuotio, Pirkka Vikatmaa, Petri T. Kovanen, Lauri Soinne, Perttu J. Lindsberg, Petra Ijäs

Primary Institution: University of Helsinki and Helsinki University Hospital

Hypothesis

The study aims to identify novel predictors for perioperative ischaemic cerebrovascular events in carotid stenosis patients undergoing carotid endarterectomy.

Conclusion

Imaging markers of past cerebrovascular disease and certain clinical factors are associated with an increased risk of perioperative ischaemic cerebrovascular events.

Supporting Evidence

  • 33 out of 488 patients experienced a perioperative ischaemic cerebrovascular event.
  • Moderate ipsilateral carotid stenosis was identified as a novel risk factor.
  • Female gender and a history of coronary heart disease were strong independent predictors of perioperative events.

Takeaway

Doctors looked at patients having surgery to clear blocked neck arteries and found that certain past brain injuries and health issues can increase the risk of having a stroke during or after the surgery.

Methodology

This was a prospective cohort study involving 488 carotid stenosis patients who underwent carotid endarterectomy, with data collected on clinical, radiological, and biomarker factors.

Potential Biases

Potential bias due to a small fraction of patients not being recruited and the observational nature of the study.

Limitations

The study may lack statistical power to detect certain associations due to the low incidence of perioperative ischaemic cerebrovascular events.

Participant Demographics

The mean age of participants was 69.6 years, with 68% being male.

Statistical Information

P-Value

0.005

Confidence Interval

95% CI 1.30–7.04

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1111/ene.16551

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