Prevention

Surgical complications are more likely with associated stroke risk factors:  

• atrial fibrillation ^b
• congestive heart failure ^b
• hypertension ^b
• a recent stroke or TIA ^b particularly if more severe ^b

Why?

Stroke risk factors increase the risk of surgical complications

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
undergoing carotid endarterectomy b	hypertension independent	stroke or death at 30 days	8.6%	1.82 (1.37 to 2.41)	17 (10 to 36)
undergoing carotid endarterectomy b	history of congestive heart failure independent	stroke or death at 30 days	8.6%	2.60 (1.20 to 5.60)	9 (4 to 65)
carotid endarterectomy b	atrial fibrillation independent	death at uncertain duration	1.2%	2.02	84
undergoing carotid endarterectomy b	monocular vs cerebral transient ischaemic attack independent	stroke or death at 30 days	8.6%	0.49 (0.37 to 0.66)	-24 (-36 to -19)

A more severe stroke increases the risk of surgical complications

Patient	Prognostic Factor	Outcome	CER	RR (95% CI)	NNF+ (95% CI)
undergoing carotid endarterectomy b	evolving stroke independent	death, stroke, myocardial infarction at 30 days	11%	7.58 (1.54 to 15.0)	1 (1 to 17)
	recent stroke independent			2.42 (1.10 to 4.84)	6 (2 to 91)
	carotid transient ischaemic attack independent			1.74 (1.06 to 2.79)	12 (5 to 150)