Accession Number : ADA256864


Title :   Use of Carotid Endarterectomy in Five California Veterans Administration Medical Centers


Corporate Author : RAND CORP SANTA MONICA CA


Personal Author(s) : Merrick, Nancy J ; Brook, Robert H ; Fink, Arlene ; Solomon, David H


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a256864.pdf


Report Date : Nov 1986


Pagination or Media Count : 8


Abstract : Although carotid endarterectomy is a controversial and frequently performed surgical procedure, little is known about the clinical appropriateness of its use in actual practice. Are the majority of procedures performed for highly accepted clinical reasons? We studied the clinical appropriateness of 107 procedures performed on 95 patients in 1981 in five Veterans Administration teaching medical centers. Standards for judging appropriate use were based on the recommendations of a multidisciplinary panel of nine physicians. Fifty-five percent of the procedures studied were judged clearly appropriate, 32% equivocal, and 13% clearly inappropriate. The rate of serious operative complications was 5.6%. These results suggest that carotid endarterectomy is over-utilized within at least some segments of the Veterans Administration population.


Descriptors :   *CAROTID ARTERIES , REPRINTS , POPULATION , PATIENTS , PHYSICIANS , CEREBROVASCULAR SYSTEM , MEDICAL PERSONNEL , VETERANS(MILITARY PERSONNEL) , JOINT TEST AND EVALUATION


Subject Categories : Administration and Management
      Anatomy and Physiology
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE