Carotid endarterectomy in a vascular fellowship training program: good results with a consistent technique.

OBJECTIVE To find out whether carotid endarterectomy performed by senior residents or vascular fellows in a vascular fellowship program with a uniform technical approach can give results equal to or better than the acceptable standard. DESIGN A case study with follow-up ranging from 121 to 1369 days. SETTING A university teaching hospital. PATIENTS Two hundred and one consecutive patients operated on between May 1989 and June 1993. INTERVENTIONS Isolated carotid endarterectomy. MAIN OUTCOME MEASURES Neurologic findings, cardiovascular complications and local wound problems after carotid endarterectomy. RESULTS There were no deaths, one permanent stroke and two significant deficits from which the patients fully recovered. CONCLUSIONS Carotid endarterectomy can be performed by senior surgical residents and vascular fellows within a vascular fellowship program, with a perioperative stroke and death rate of less than 1% when a uniform approach is used.