Patients Requiring Dialysis are not at Risk of Greater Complication after Carotid Endarterectomy

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Stroke is a leading cause of disability and the third leading cause of death. Landmark studies have demonstrated that carotid endarterectomy (CEA) reduced the risk of stroke among selected patients with carotid stenosis. Renal insufficiency is a known risk factor for stroke and appears to be an independent risk factor for poor outcome after CEA. Studies have reported high morbidity and mortality after CEA in patients on dialysis. However, our experience has been that patients undergoing dialysis have no greater risk for a poor outcome. This study was a retrospective review of our CEA patients to ascertain our morbidity and mortality results in dialysis patients versus patients not on dialysis. An institutional retrospective chart review of CEAs from January 1999 to December 2007 was conducted. Patients on dialysis at the time of CEA were identified. Their charts were reviewed for complications 30 days after surgery. This was compared with our total experience with CEAs from January 1999 to December 2007. Of the 28 patients undergoing CEA while dialysis dependent, none had complications in the 30-day postoperative period. This compares favorably with the cohort of all CEAs by the same surgeons. In that group, 13 complications were identified (13 of 1,141). Patients undergoing dialysis are at no greater risk for complications when undergoing carotid endarterectomy than the general population.