Carotid Endarterectomies in Latvia

Introduction. Carotid endarterectomy (CEA) is a treatment of choice for significant carotid stenosis, and it has an important role in stroke prophylaxis, that is proved in many trials all over the world. Aim of the study. To evaluate preoperative diagnostic methods, risk factors and co-morbidities, operation results for patients undergoing CEA in Latvia. To analyze used anaesthasia and operation technique in CEA in Latvia. To reflect carotid endarterecomy results that depends from chosen operation technique. Materials and methods. 317 patients were included in the retrospective study from January 1st till December 31st, 2008. Patient charts were evaluated for information about history of disease and other comorbidities, preoperative investigation, operation and early postoperative period followed by protocol. All patients were divided into three groups depending on type of endarterectomy (CEA with primary suture, with patch or eversion CEA). Results. In 59% cases carotid disease were asymptomatic. Computer tomography angiography (CTA) and duplex ultrasound were the most common diagnostic methods to evaluate carotid stenosis. 339 carotid endarterectomies were performed, where CEA with primary suture was used in 56.2% of cases (group 1). There were no significant diferences in patient atherosclerotic risks factors, comorbidities, preoperative investigation methods, time of surgery and complications rate between the groups. Conclusions. In Latvia carotid endarterectomy is carried out mostly in classical conventional tecniques and arteriotomy is being closed with a primary suture.