PT  - JOURNAL ARTICLE
AU  - D Dellagrammaticas
AU  - S Lewis
AU  - B Colam
AU  - PM Rothwell
AU  - CP Warlow
AU  - MJ Gough
TI  - Carotid endarterectomy in the UK: acceptable risks but unacceptable delays
AID  - 10.7861/clinmedicine.7-6-589
DP  - 2007 Dec 01
TA  - Clinical Medicine
PG  - 589--592
VI  - 7
IP  - 6
4099  - http://www.rcpjournals.org/content/7/6/589.short
4100  - http://www.rcpjournals.org/content/7/6/589.full
SO  - Clin Med2007 Dec 01; 7
AB  - Carotid endarterectomy (CEA) is of benefit for stroke prevention in the presence of severe carotid stenosis, provided surgical morbidity and mortality are acceptably low. To assess the current performance of CEA in the UK, an interim analysis of 30-day postoperative outcome data, blinded to anaesthetic allocation, from the first 1,001 UK patients randomised in the GALA Trial (multicentre randomised trial of general versus local anaesthesia for CEA) took place and the time from last symptomatic event to surgery was recorded. The 30-day risk of stroke was 5.3%, myocardial infarction (MI) 0.4%, death 1.7%, and stroke, MI or death 6.4%. Median delay between symptoms and surgery was 82 days. These risks are similar to those reported in the large randomised trials of CEA, but current delays to surgery are excessive and must have substantially reduced the benefit of endarterectomy.