Assessment of carotid endarterectomy in iran

Carotid Endarterectomy (CEA) is recommended in patients with symptomatic and some times asymptomatic carotid stenosis in vascular surgery centers with low perioperative complication rate. A retrospecticve study was carried out in patients who underwent CEA in 3 vascular surgery centers in Tehran and 2 centers in Mashhad. Patients selection criteria, methods of detection of carotid stenosis, method of anesthesia, surgical techniques and perioperative complications were evaluated. 388 CEA in 345 patients (65% males) with mean age of 66.8 years ranged 46-84 years were evaluated. Detection of carotid stenosis was made by one carotid duplex ultrasound in 90% of CEA candidates. The whole perioperative stroke and death rate in reported Iranian vascular surgery centers is 6.4%. Perioperative stroke and death rate in Emam Reza, Razavi, Shohada Tajrish, Taleghani and Iranmehr hospitals was 2.4%, 0%, 4.8%, 10.2% and 10.2% respectively. In Iran, CEA is recommended only in patients with symptomatic ≥70% ICA stenosis and preferably in patients with symptomatic ≥90% ICA stenosis. Method of detection of carotid stenosis in Iranian vascular surgery centers should be corrected.