Carotid Artery Surgery Brings Higher Than Expected Risk

Odds for stroke, heart attack especially high for black patients, study finds

By Steven Reinberg
HealthDay Reporter

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THURSDAY, Feb. 8 (HealthDay News) -- A procedure designed to clear blockages from the neck's carotid arteries appears to be riskier in real life than it seemed in clinical trails, researchers report.

The procedure, called carotid endarterectomy, "is the most common surgery performed to prevent stroke," noted study author Dr. Seemant Chaturvedi, a professor of neurology and director of the Wayne State University Stroke Program in Detroit.

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"Previous studies have found that the risk/benefit ratio of the surgery is fairly narrow. There is a fine line of providing benefit to the patient and not providing benefit," he said.

That line may have been crossed for some patients, according to the new study, which was expected to be presented Thursday at the American Stroke Association annual meeting in San Francisco.

In carotid endarterectomy, surgeons open up clogged carotid vessels, pull out accumulated plaque, then suture the artery up again.

In their study, Chaturvedi and colleagues collected data on carotid endarterectomies performed in two Detroit hospitals.

One hospital performed 99 carotid endarterectomies during the study period, the other performed 51. Among all patients, 69 percent had no symptoms before undergoing the procedure. About 60 percent of the patients were black. Many patients in the study had high blood pressure, diabetes or smoked, Chaturvedi said.

The team found significantly more complications associated with the surgery -- particularly among black patients -- than expected.

For people without symptoms, the complication rate in terms of suffering a stroke or dying during the procedure should be less than 3 percent, Chaturvedi said. And "the majority of carotid endarterectomies are done on asymptomatic patients -- 70 to 80 percent," he noted.

However, the researchers pegged the rate of stroke during carotid endarterectomy at 4.7 percent, while the expected rate was 3.1 percent. The rate of heart attacks was 6.7 percent; however, the expected rate was 0.4 percent.

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