| Delayed Carotid Surgery: What Are the Causes in the North West of England? | |
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MedLine Citation:
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PMID: 22507922 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: Carotid endarterectomy (CEA) should be performed within two weeks of symptoms for patients with carotid stenosis >50%. Whether these standards are being achieved and causes of delay between symptoms and CEA were investigated. DESIGN: An analysis of prospectively collected multi-centre data. MATERIALS: Consecutive data for patients undergoing CEA between January-2006 and September-2010 were collected. Asymptomatic patients and those with no details on the timing of cerebral symptoms were excluded. METHODS: 'Delay' from symptom to CEA was defined as more than two weeks and 'prolonged-delay' more than eight weeks. Univariable and multivariable analyses were used to identify factors associated with these delays. RESULTS: Of 2147 patients with symptoms of cerebral ischaemia, 1522(70.9%) experienced 'delay' and 920(42.9%) experienced 'prolonged delay'. Patients with ischaemic heart disease were more likely to experience 'delay' (OR = 1.56; 95% CI 1.11-2.19, p = 0.011), whereas patients with stroke (OR = 0.77; 95%CI 0.63-0.94, p = 0.011) and those treated at hospitals with a stroke-prevention clinic (OR = 0.57; 95%CI 0.46-0.71, p < 0.001) were less likely to experience 'delay'. Patients treated after the publication of National Institute for Health and Clinical Excellence (NICE) guidelines were less likely to experience 'prolonged delay' (OR = 0.77; 95%CI 0.65-0.91, p = 0.003) but not 'delay'. CONCLUSION: Few patients achieved CEA within two weeks of symptoms. Introducing stroke-prevention clinics with one-stop carotid imaging appears important. |
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Authors:
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D Purkayastha; S W Grant; J V Smyth; C N McCollum |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-14 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: - ISSN: 1532-2165 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Vascular Governance North West, 1st Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester, England, M23 9LT, United Kingdom. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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