Are one-day admissions for carotid endarterectomy feasible?
Department of Surgery, Sewickley Valley Hospital, Pennsylvania, USA. BACKGROUND: In 1990, a clinical pathway for streamlining the care of patients undergoing elective carotid endarterectomy was developed and tested at our institution. This consisted of extensive preoperative patient education in the surgeon’s office, outpatient arteriography (now performed only on select patients), same-day admission, regional anesthesia when possible, selective use of the intensive care unit (ICU), and early discharge in the first postoperative day when feasible. PATIENTS AND METHODS: Between January 1, 1991 and June 30, 1994, 186 patients were entered into the protocol. Twenty-six percent of the patients were asymptomatic, while 74% had either transient symptoms or a prior stroke; 13% were operated on under general anesthesia. RESULTS: Three (1.6%) patients developed neurologic complications: 1 minor stroke, 1 transient ischemic attack, and 1 intracerebral hematoma; and 18 (10%) patients required the
