ArticleStroke2019
Associations of Perioperative Variables With the 30-Day Risk of Stroke or Death in Carotid Endarterectomy for Symptomatic Carotid Stenosis.
Article in Stroke, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Influences of age and gender on operative risks following carotid endarterectomy: A systematic review and meta-analysis.PloS one · 2023Pooled it
- [Important recommendations of the German-Austrian S3 guidelines on management of extracranial carotid artery stenosis].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2022Guideline
- Diagnosis, Treatment and Follow-up in Extracranial Carotid Stenosis.Deutsches Arzteblatt international · 2020Pooled it
- Carotid endarterectomy for symptomatic carotid stenosis.The Cochrane database of systematic reviews · 2020Pooled it
- Treatment and Procedures for Ischemic Strokes of Vascular Etiology: Experience of the Eastern Slovakia Stroke Center.Cureus · 2026Article
- The role of contrast-enhanced transcranial color-coded real-time sonography combined with the common carotid artery compression test in preoperative evaluation of anterior communicating artery patency in patients with insufficient temporal bone windows.Frontiers in neurology · 2026Article
- Risk factors for perioperative stroke, myocardial infarction, and death in patients undergoing carotid endarterectomy under local anesthesia: a systematic review and meta-analysis.Frontiers in surgery · 2025Review
- Learnability of Ultrasound-Guided Locoregional Anesthesia for Carotid Endarterectomy.Journal of clinical medicine · 2024Article
- Brazilian Angiology and Vascular Surgery Society Guidelines for the treatment of extracranial cerebrovascular disease.Jornal vascular brasileiro · 2024Article
- In-hospital outcomes after upper extremity versus transfemoral and transcarotid access for carotid stenting in the Vascular Quality Initiative.Journal of vascular surgery · 2022Article
- The Gupta Perioperative Risk for Myocardial Infarct or Cardiac Arrest (MICA) Calculator as an Intraoperative Neurologic Deficit Predictor in Carotid Endarterectomy.Journal of clinical medicine · 2022Article
- Lipid-related protein NECTIN2 is an important marker in the progression of carotid atherosclerosis: An intersection of clinical and basic studies.Journal of translational internal medicine · 2021Article
- Article
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
Background and Purpose- This analysis was performed to assess the association between perioperative and clinical variables and the 30-day risk of stroke or death after carotid endarterectomy for symptomatic carotid stenosis. Methods- Individual patient-level data from the 5 largest randomized controlled carotid trials were pooled in the Carotid Stenosis Trialists' Collaboration database. A total of 4181 patients who received carotid endarterectomy for symptomatic stenosis per protocol were included. Determinants of outcome included carotid endarterectomy technique, type of anesthesia, intraoperative neurophysiological monitoring, shunting, antiplatelet medication, and clinical variables. Stroke or death within 30 days after carotid endarterectomy was the primary outcome. Adjusted risk ratios (aRRs) were estimated in multilevel multivariable analyses using a Poisson regression model. Results- Mean age was 69.5±9.2 years (70.7% men). The 30-day stroke or death rate was 4.3%. In the multivariable regression analysis, local anesthesia was associated with a lower primary outcome rate (versus general anesthesia; aRR, 0.70 [95% CI, 0.50-0.99]). Shunting (aRR, 1.43 [95% CI, 1.05-1.95]), a contralateral high-grade carotid stenosis or occlusion (aRR, 1.58 [95% CI, 1.02-2.47]), and a more severe neurological deficit (mRS, 3-5 versus 0-2: aRR, 2.51 [95% CI, 1.30-4.83]) were associated with higher primary outcome rates. None of the other characteristics were significantly associated with the perioperative stroke or death risk. Conclusions- The current results indicate lower perioperative stroke or death rates in patients operated upon under local anesthesia, whereas a more severe neurological deficit and a contralateral high-grade carotid stenosis or occlusion were identified as potential risk factors. Despite a possible selection bias and patients not having been randomized, these findings might be useful to guide surgeons and anesthetists when treating patients with symptomatic carotid disease.
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