{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:59:53Z","timestamp":1774331993235,"version":"3.50.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T00:00:00Z","timestamp":1325808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Carotid endarterectomy (CEA) reduces the risk of stroke in patients with internal carotid stenosis of 50\u201399 per cent. This study assessed national surgical practice through audit of CEA procedures and outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a prospective cohort study of UK surgeons performing CEA, using clinical audit data collected continuously and reported in two rounds, covering operations from December 2005 to December 2007, and January 2008 to September 2009.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 352 (92\u00b76 per cent) of 380 eligible surgeons contributed data. Of 19 935 CEAs recorded by Hospital Episode Statistics, 12 496 (62\u00b77 per cent) were submitted to the audit. A total of 10 452 operations (83\u00b76 per cent) were performed for symptomatic carotid stenosis; among these patients, the presenting symptoms were transient ischaemic attack in 4507 (43\u00b71 per cent), stroke in 3572 (34\u00b72 per cent) and amaurosis fugax in 1965 (18\u00b78 per cent). The 30-day mortality rate was 1\u00b70 per cent (48 of 4944) in round 1 and 0\u00b78 per cent (50 of 6151) in round 2; the most common cause of death was stroke, followed by myocardial infarction. The rate of death or stroke within 30 days of surgery was 2\u00b75 per cent (124 of 4918) in round 1 and 1\u00b78 per cent (112 of 6135) in round 2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>CEA is performed less commonly in the UK than in other European countries and probably remains underutilized in the prevention of stroke. Increasing the number of CEAs done in the UK, together with reducing surgical waiting times, could prevent more strokes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.7810","type":"journal-article","created":{"date-parts":[[2011,12,21]],"date-time":"2011-12-21T10:40:50Z","timestamp":1324464050000},"page":"209-216","source":"Crossref","is-referenced-by-count":21,"title":["Current practice of carotid endarterectomy in the UK"],"prefix":"10.1093","volume":"99","author":[{"given":"N","family":"Rudarakanchana","sequence":"first","affiliation":[{"name":"Northwick Park Hospital , Harrow,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A W","family":"Halliday","sequence":"additional","affiliation":[{"name":"John Radcliffe Hospital , Oxford,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Kamugasha","sequence":"additional","affiliation":[{"name":"Royal College of Physicians ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Grant","sequence":"additional","affiliation":[{"name":"St George's, University of London and Kingston University ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Waton","sequence":"additional","affiliation":[{"name":"Royal College of Physicians ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Horrocks","sequence":"additional","affiliation":[{"name":"Royal United Hospitals , Bath,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A R","family":"Naylor","sequence":"additional","affiliation":[{"name":"Leicester Royal Infirmary , Leicester,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A G","family":"Rudd","sequence":"additional","affiliation":[{"name":"St Thomas' Hospital , London,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G C","family":"Cloud","sequence":"additional","affiliation":[{"name":"Royal College of Physicians ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Mitchell","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust , Bristol,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2012,2,1]]},"reference":[{"key":"2024092904520909000_bib1","first-page":"141","volume-title":"Heath Care Needs Assessment: the Epidemiology Based Needs Assessment Reviews","author":"Mant","year":"2004","edition":"2nd"},{"key":"2024092904520909000_bib2","volume-title":"World Health Report 2004 Changing History","author":"World Health Organization","year":"2004"},{"key":"2024092904520909000_bib3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/ageing\/afn281","article-title":"Cost of stroke in the United Kingdom","volume":"38","author":"Saka","year":"2009","journal-title":"Age Ageing"},{"key":"2024092904520909000_bib4","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1093\/eurheartj\/ehi733","article-title":"Economic burden of cardiovascular diseases in the enlarged European Union","volume":"27","author":"Leal","year":"2006","journal-title":"Eur Heart J"},{"key":"2024092904520909000_bib5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejvs.2008.11.006","article-title":"Invasive treatment for carotid stenosis: indications, techniques","volume":"37","author":"Liapis","year":"2009","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024092904520909000_bib6","doi-asserted-by":"crossref","DOI":"10.1596\/978-0-8213-6262-4","volume-title":"Global Burden of Disease & Risk Factors","author":"Lopez","year":"2006"},{"key":"2024092904520909000_bib7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta6070","article-title":"The cost-effectiveness of magnetic resonance angiography for carotid artery stenosis and peripheral vascular disease: a systematic review","volume":"6","author":"Berry","year":"2002","journal-title":"Health Technol Assess"},{"key":"2024092904520909000_bib8","first-page":"1421","article-title":"Executive Committee for the Asymptomatic Carotid Atherosclerosis Study","volume":"273","author":"Endarterectomy for asymptomatic carotid artery stenosis","year":"1995","journal-title":"JAMA"},{"key":"2024092904520909000_bib9","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1016\/S0140-6736(04)16146-1","article-title":"Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial","volume":"363","author":"Halliday","year":"2004","journal-title":"Lancet"},{"key":"2024092904520909000_bib10","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/0140-6736(91)92916-P","article-title":"MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70\u201399%) or with mild (0\u201329%) carotid stenosis","volume":"337","author":"European Carotid Surgery Trialists' Collaborative Group","year":"1991","journal-title":"Lancet"},{"key":"2024092904520909000_bib11","first-page":"445","article-title":"North American Symptomatic Carotid Endarterectomy Trial Collaborators","volume":"325","author":"Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade stenosis","year":"1991","journal-title":"N Engl J Med"},{"key":"2024092904520909000_bib12","author":"Health and Social Care Information Centre","year":"2011","journal-title":"Hospital Episode Statistics"},{"key":"2024092904520909000_bib13","volume-title":"Reducing Brain Damage: Faster Access to Better Stroke Care","author":"National Audit Office (NAO)","year":"2005"},{"key":"2024092904520909000_bib14","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/S0140-6736(04)15785-1","article-title":"Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery","volume":"363","author":"Rothwell","year":"2004","journal-title":"Lancet"},{"key":"2024092904520909000_bib15","author":"National Institute for Health and Clinical Excellence","year":"2011","journal-title":"Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack (TIA)"},{"key":"2024092904520909000_bib16","author":"Department of Health","year":"2011","journal-title":"National Stroke Strategy"},{"key":"2024092904520909000_bib17","doi-asserted-by":"crossref","first-page":"b1847","DOI":"10.1136\/bmj.b1847","article-title":"Waiting times for carotid endarterectomy in UK: observational study","volume":"338","author":"Halliday","year":"2009","journal-title":"BMJ"},{"key":"2024092904520909000_bib18","author":"Karbase Landsregister","year":"2010"},{"key":"2024092904520909000_bib19","author":"Swedvasc","year":"2010"},{"key":"2024092904520909000_bib20","author":"Bundesgesch\u00e4ftsstelle f\u00fcr Qualit\u00e4tssicherung","year":"2010"},{"key":"2024092904520909000_bib21","author":"Swissvasc","year":"2010"},{"key":"2024092904520909000_bib22","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1212\/01.WNL.0000170368.82460.b4","article-title":"Population-based study of delays in carotid imaging and surgery and the risk of recurrent stroke","volume":"65","author":"Fairhead","year":"2005","journal-title":"Neurology"},{"key":"2024092904520909000_bib23","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1016\/S0140-6736(07)61448-2","article-title":"Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison","volume":"370","author":"Rothwell","year":"2007","journal-title":"Lancet"},{"key":"2024092904520909000_bib24","doi-asserted-by":"crossref","first-page":"589","DOI":"10.7861\/clinmedicine.7-6-589","article-title":"Carotid endarterectomy in the UK: acceptable risks but unacceptable delays","volume":"7","author":"Dellagrammaticas","year":"2007","journal-title":"Clin Med"},{"key":"2024092904520909000_bib25","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1177\/003693300404900206","article-title":"Improvements in carotid endarterectomy in Scotland: results of a national prospective survey","volume":"49","author":"Pell","year":"2004","journal-title":"Scott Med J"},{"key":"2024092904520909000_bib26","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S1078-5884(97)80289-4","article-title":"Carotid endarterectomy in the U.K. and Ireland: audit of 30-day outcome. Audit Committee for the Vascular Surgical Society","volume":"14","author":"McCollum","year":"1997","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024092904520909000_bib27","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1161\/01.STR.0000128529.63156.c5","article-title":"Stroke agreement between ambulance paramedic- and physician-recorded neurological signs with Face Arm Speech Test (FAST) in acute stroke patients","volume":"35","author":"Nor","year":"2004","journal-title":"Stroke"},{"key":"2024092904520909000_bib28","author":"Department of Health","year":"2011","journal-title":"Implementing the National Stroke Strategy\u2014an Imaging Guide"},{"key":"2024092904520909000_bib29","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.avsg.2009.06.004","article-title":"Safety of carotid endarterectomy in patients concurrently on clopidogrel","volume":"23","author":"Fleming","year":"2009","journal-title":"Ann Vasc Surg"},{"key":"2024092904520909000_bib30","doi-asserted-by":"crossref","first-page":"908","DOI":"10.3171\/2009.12.JNS09707","article-title":"Safety of carotid endarterectomy while on clopidogrel (Plavix). Clinical article","volume":"113","author":"Wait","year":"2010","journal-title":"J Neurosurg"},{"key":"2024092904520909000_bib31","doi-asserted-by":"crossref","first-page":"2132","DOI":"10.1016\/S0140-6736(08)61699-2","article-title":"General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial","volume":"372","author":"GALA Trial Collaborative Group","year":"2008","journal-title":"Lancet"},{"issue":"1","key":"2024092904520909000_bib32","first-page":"CD001921","article-title":"Eversion versus conventional carotid endarterectomy for preventing stroke","author":"Cao","year":"2001","journal-title":"Cochrane Database Syst Rev"},{"key":"2024092904520909000_bib33","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S0741-5214(00)70064-4","article-title":"Eversion versus conventional carotid endarterectomy: late results of a prospective multicenter randomized trial","volume":"31","author":"Cao","year":"2000","journal-title":"J Vasc Surg"},{"key":"2024092904520909000_bib34","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD000190.pub2","article-title":"Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting)","author":"Rerkasem","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"2024092904520909000_bib35","first-page":"CD000160","article-title":"Patch angioplasty versus primary closure for carotid endarterectomy","author":"Rerkasem","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"2024092904520909000_bib36","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.amjsurg.2004.07.028","article-title":"Short-stay carotid endarterectomy in a tertiary-care Veterans Administration hospital","volume":"188","author":"Cikrit","year":"2004","journal-title":"Am J Surg"},{"key":"2024092904520909000_bib37","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/S0140-6736(10)60239-5","article-title":"Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomized controlled trial","volume":"375","author":"International Carotid Stenting Study Investigators","year":"2010","journal-title":"Lancet"},{"key":"2024092904520909000_bib38","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1161\/STROKEAHA.110.595330","article-title":"The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease","volume":"41","author":"Mantese","year":"2010","journal-title":"Stroke"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.7810","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/99\/2\/209\/59424475\/bjs7810.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/99\/2\/209\/59424475\/bjs7810.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T04:52:42Z","timestamp":1727585562000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/99\/2\/209\/6140966"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1,6]]},"references-count":38,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2012,2,1]]},"published-print":{"date-parts":[[2012,1,6]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.7810","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2012,2]]},"published":{"date-parts":[[2012,1,6]]}}}