Factors That Influence the Occurrence of Acute Postoperative Complications after Carotid Endarterectomy

ABSTRACT
Background: This study aimed to identify early postoperative complications after carotid endarterectomy and the factors that may influence their occurrence. Methods: This was an observational, analytical, prospective study conducted over a period of 3 years in 2 university hospitals in Târgu Mureș, Romania. One hundred nineteen patients who underwent carotid
endarterectomy for severe carotid stenosis were included. Statistical analysis was used to identify the independent factors with a direct influence on the acute complications in the first 48 h after carotid endarterectomy. Results: We followed up on the acute postoperative complications occurring in the first 2 days after surgery. These were represented by a limited number of neurological complications and major neck hematomas. Among all comorbidities and risk factors, only advanced coronary artery disease (p = 0.05) and smoking (p = 0.03) were independent factors that directly influenced the occurrence of major neck hematomas. Operative time exceeding the median time of 90 minutes increased the risk of neurological complications (p = 0.02). The risk of major neck hematomas was also increased by preoperative treatment with anticoagulants (p = 0.01) and anticoagulants associated with antiplatelet therapy (p = 0.009). Conclusions: This study has identified factors such as advanced coronary artery disease, smoking, operative time, and anticoagulant therapy that may be independently associated with an increased risk of acute postoperative complications after carotid endarterectomy.