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- W2770690526 abstract "Most guidelines recommend fast-track carotid endarterectomy (CEA) within 14 days of the last ischemic event. Long-term survival after fast-track CEA is unknown. The purpose of this study was to determine whether the fast-track CEA program in our region was associated with a reduced or increased 2-year survival and overall complication rate in our population.Prospective 2-year follow-up in patients after the implementation of a fast-track CEA program during a period of 3½ years. Data on recurrent stroke, myocardial infarction, and death in a 2-year period after CEA were collected along with the indication for surgery and the time from ischemic event to the operation.Two hundred patients underwent CEA. The overall complication rate for 30 days was 3.5% (95% confidence interval [CI], 2%-5%) and 15.5% (95% CI, 13%-18%) for 2 years. During the 2-year follow-up 17 patients (8.5%; 95% CI, 7%-10%) died. Eight patients (4%; 95% CI, 2%-6%) died of advanced cancer (undiagnosed at the index event and CEA time). Of the 6 deaths occurring in patients undergoing CEA 14 days after the index event or earlier, 5 patients (83%; 95% CI, 55%-95%) died of advanced cancer. In the 11 deaths in patients who underwent CEA more than 14 days after the index event, 3 patients (27%; 95% CI, 5%-50%) died of cancer. This was a statistically significant difference (P = .049).Fast-track CEA is a safe procedure in selected patients. Our results show a potential significant risk of overlooking occult cancer, which may affect the long-term benefit from prophylactic CEA." @default.
- W2770690526 created "2017-12-04" @default.
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- W2770690526 date "2018-03-01" @default.
- W2770690526 modified "2023-09-26" @default.
- W2770690526 title "Midt-Term Results after Fast-Track Prophylactic Carotid Surgery Program: The Risk of Overlooking Occult Cancer" @default.
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- W2770690526 doi "https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.10.001" @default.
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