Table I.
Preoperative characteristics and operative details for patients undergoing CEA in baseline risk group and patients undergoing CEA/CABG
| Variable | Isolated CEA in non-CEA/CABG centers | CEA/CABG | P value | Of 109 total CEA/CABG:
|
||
|---|---|---|---|---|---|---|
| Low-risk group | High-risk group | P value | ||||
| Number of patients | 1563 | 109 | 61 | 48 | ||
| Male gender | 922 (59%) | 75 (69%) | .04 | 40 (66%) | 35 (73%) | .41 |
| Right side | 781 (50%) | 51 (47%) | .52 | 29 (48%) | 22 (46%) | .86 |
| White race | 1532 (98%) | 108 (99%) | .43 | 60 (98%) | 48 (100%) | .37 |
| Mean age | 70.2 (69.7–70.7) | 69.0 (67.1–70.8) | .2 | 69.2 (66.6–71.8) | 68.7 (66.0–71.5) | .81 |
| Age | ||||||
| <40 years | 2 (<1%) | 0 (0%) | .71 | 0 (0%) | 0 (0%) | — |
| Age 40–49 years | 40 (3%) | 5 (5%) | .21 | 3 (5%) | 2 (4%) | .85 |
| Age 50–59 years | 190 (12%) | 12 (11%) | .72 | 8 (13%) | 4 (8%) | .43 |
| Age 60–69 years | 462 (30%) | 38 (35%) | .24 | 19 (31%) | 19 (40%) | .36 |
| Age 70–79 years | 604 (39%) | 40 (37%) | .69 | 23 (38%) | 17 (36%) | .81 |
| Age 80–89 years | 249 (16%) | 13 (12%) | .27 | 7 (11%) | 6 (13%) | .87 |
| Age >90 years | 16 (1%) | 1 (1%) | .92 | 1 (2%) | 0 (0%) | .37 |
| Smoking (prior or current) | 1190 (76%) | 87 (80%) | .68 | 44 (72%) | 43 (90%) | .02 |
| Diabetes | 455 (29%) | 48 (44%) | .001 | 28 (46%) | 20 (42%) | .66 |
| Creatinine ≥1.8 mg/dL | 77 (5%) | 12 (11%) | .007 | 6 (10%) | 6 (13%) | .66 |
| Dialysis | 10 (1%) | 0 (0%) | .61 | 0 (0%) | 0 (0%) | — |
| Hypertension | 1368 (88%) | 97 (89%) | .69 | 55 (90%) | 42 (88%) | .66 |
| Prior CABG or coronary intervention | 394 (25%) | 29 (27%) | .76 | 19 (31%) | 10 (21%) | .23 |
| Congestive heart failure | 155 (10%) | 25 (23%) | .00002 | 10 (16%) | 15 (31%) | .07 |
| Prior radiation therapy | 21 (1%) | 1 (1%) | .7 | 1 (1.6%) | 0 (0%) | .37 |
| Preoperative medication regimen | ||||||
| Aspirin | 1430 (92%) | 103 (95%) | .56 | 58 (95%) | 45 (94%) | .76 |
| Clopidogrel | 386 (25%) | 8 (7%) | .0002 | 3 (5%) | 5 (10%) | .27 |
| Aspirin and clopidogrel | 333 (21%) | 7 (6%) | .0002 | 3 (5%) | 4 (8%) | .47 |
| Statin use | 1169 (75%) | 85 (78%) | .69 | 47 (77%) | 28 (79%) | .79 |
| Beta blockers | 1173 (75%) | 102 (94%) | .00001 | 56 (92%) | 46 (96%) | .39 |
| Symptom status | ||||||
| Asymptomatic | 966 (62%) | 89 (82%) | .00003 | 61 (100%) | 28 (58%) | 2 × 10−8 |
| Any symptom | 597 (38%) | 20 (18%) | .00003 | 0 (0%) | 20 (42%) | 2 × 10−8 |
| Ipsilateral symptoms (TIA or stroke) | 363 (23%) | 12 (11%) | .003 | 0 (0%) | 12 (25%) | .00003 |
| Contralateral symptoms (TIA or stroke) | 116 (7%) | 4 (4%) | .14 | 0 (0%) | 4 (8%) | .22 |
| Vertebrobasilar symptoms (TIA or stroke) | 57 (4%) | 1 (1%) | .13 | 0 (0%) | 1 (2%) | .26 |
| Nonspecific | 172 (11%) | 7 (6%) | .13 | 0 (0%) | 7 (15%) | .002 |
| Ipsilateral degree of stenosis | ||||||
| <50% stenosis | 23 (1%) | 0 (0%) | .2 | 0 (0%) | 0 (0%) | — |
| >50% stenosis | 1511 (97%) | 108 (99%) | .17 | 61 (100%) | 47 (98%) | .26 |
| >60% stenosis | 1450 (93%) | 108 (99%) | .011 | 61 (100%) | 47 (98%) | .26 |
| >70% stenosis | 1341 (86%) | 105 (96%) | .002 | 60 (98%) | 45 (94%) | .2 |
| >80% stenosis | 1002 (64%) | 69 (63%) | .87 | 33 (54%) | 36 (75%) | .03 |
| Occluded | 22 (1%) | 1 (1%) | .67 | 0 (0%) | 1 (2%) | .26 |
| Contralateral degree of stenosis | ||||||
| <50% stenosis | 989 (63%) | 41 (38%) | 1 × 10−7 | 33 (54%) | 8 (17%) | .00006 |
| <50% stenosis | 451 (29%) | 52 (48%) | .00003 | 26 (43%) | 26 (54%) | .23 |
| >60% stenosis | 282 (18%) | 35 (32%) | .0003 | 13 (21%) | 22 (46%) | .006 |
| >70% stenosis | 181 (12%) | 18 (17%) | .12 | 0 (0%) | 18 (34%) | 2 × 10−7 |
| >80% stenosis | 69 (4%) | 7 (6%) | .33 | 0 (0%) | 7 (15%) | .002 |
| Occluded | 82 (5%) | 14 (13%) | .001 | 0 (0%) | 14 (29%) | 6 × 10−6 |
| Operative characteristics | ||||||
| Urgency | ||||||
| Elective | 1321 (85%) | 76 (70%) | .00004 | 49 (80%) | 27 (56%) | .007 |
| Urgent or emergent | 239 (15%) | 33 (30%) | .00004 | 12 (20%) | 21 (44%) | .007 |
| Local/regional anesthesia | 55 (4%) | 4 (4%) | .98 | |||
| General anesthesia | 1505 (96%) | 105 (96%) | .98 | 59 (97%) | 46 (96%) | .81 |
| Conventional CEA | 1519 (97%) | 88 (81%) | 7 × 10−19 | 47 (77%) | 41 (85%) | .27 |
| Conventional CEA with primary closure | 35 (2%) | 16 (15%) | 3 × 10−13 | 8 (13%) | 8 (17%) | .6 |
| Conventional CEA with patch | 1484 (95%) | 72 (66%) | 2 × 10−30 | 39 (64%) | 33 (69%) | .6 |
| Eversion endarterectomy | 41 (3%) | 21 (19%) | 7 × 10−19 | 14 (23%) | 7 (15%) | .27 |
| Routine shunting | 1416 (91%) | 12 (11%) | 4 × 10−103 | 6 (10%) | 6 (13%) | .66 |
| Shunting for neurologic changes (indication) | 12 (1%) | 9 (8%) | 1 × 10−11 | 4 (7%) | 5 (10%) | .47 |
| Dextran use | 21 (1%) | 18 (17%) | 4 × 10−24 | 14 (23%) | 4 (8%) | .04 |
| Protamine use | 986 (63%) | 88 (81%) | .0002 | 48 (79%) | 40 (83%) | .54 |
CABG, Coronary artery bypass graft; CEA, carotid endarterectomy; TIA, transient ischemic attack.