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Discusses the abstract of a study evaluating the safety of vein versus dacron patching during carotid endarterectomy. Patient characteristics; Stroke rate for dacron- versus vein-patched patients; Incidence of detecting emboli in dacron- versus vein-patched group.

Background Vascular surgeons perceive that carotid endarterectomy carries a higher risk of stroke if performed by a surgical trainee. Accordingly, some trainees consider that they receive a less than adequate training in carotid surgery before taking up a consultant position. The aim of this study was to establish whether the stroke rate was adversely affected if carotid endarterectomy was performed by a surgical trainee under consultant supervision. Methods This was a prospective study of 151 consecutive patients undergoing carotid endarterectomy between 1 January and 31 December 1996 using a standardized technique including intraoperative and postoperative transcranial Doppler monitoring and completion angioscopy. Results The overall mortality and/or disabling stroke rate was 0·7 per cent (one of 151 patients), whereas the mortality and/or any stroke rate was 1·3 per cent (two of 151). Surgical trainees performed 82 of 151 carotid endarterectomies, with a mortality rate of 1 per cent and a mortality and/or any stroke rate of 2 per cent. There was no significant difference in the incidence of retained thrombus or intimal flaps between trainees and consultants as detected by angioscopy. Conclusion Vascular surgical trainees can receive a comprehensive training in carotid artery surgery without incurring an unacceptable increase in operative risk. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the risk of death and/or stroke in patients following carotid endarterectomy. Methodology; Results and discussion.