Carotid endarterectomy in a neurosurgical unit: a retrospective review.

A retrospective survey of 262 carotid endarterectomies performed in the Neurosurgical Unit at Royal Prince Alfred Hospital over a 15 year period was conducted. A total of 141 patients were operated on for transient ischaemic attacks referable to stenosis of the ipsilateral internal carotid artery. Eighty-eight percent of patients had angiographic evidence of greater than 80% stenosis of the affected internal carotid artery. A postoperative new permanent neurological deficit of 1.9% and death rate of 0.6% was achieved. No deaths and two postoperative strokes were recorded after 1987. These results are comparable with published series. The use of barbiturate therapy with electroencephalography changes on cross clamping of the internal carotid artery is described. Copyright 1999 Harcourt Publishers Ltd.