SELECTION PROCESS FOR SURGEONS IN THE ASYMPTOMATIC CAROTID ATHEROSCLEROSIS STUDY
SELECTION PROCESS FOR SURGEONS IN THE ASYMPTOMATIC CAROTID ATHEROSCLEROSIS STUDY
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DOI：
10.1161/01.str.22.11.1353
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发表时间：
1991-11-01
期刊：
影响因子：
8.3
通讯作者：
TOOLE, JF
中科院分区：
文献类型：
--
作者：
MOORE, WS;VESCERA, CL;TOOLE, JF
背景和目的：无症状颈动脉粥样硬化研究是一项前瞻性、多中心、随机临床试验，研究颈动脉内膜切除术治疗无症状血流动力学显著狭窄。本报告描述了选择过程中参与外科医生在trial.Methods：外科管理委员会建立了指导方针，最低的年度经验和最大的神经系统的发病率和死亡率的外科医生有资格参加这项研究。为了获得批准，外科医生必须每年至少进行12次颈动脉内膜切除术。根据外科医生的最后50个连续动脉内膜切除术的审查，合并神经系统的发病率和死亡率必须不超过5%的所有适应症和不超过3%的动脉内膜切除术上进行无症状patients.Results：一百六十四名外科医生从48个中心申请批准：117被批准，17被拒绝，30没有审查。这117名经批准的外科医生共提交了5，641例动脉内膜切除术，合并死亡率和神经系统发病率为2.3%，用于各种手术适应症。结论：颈动脉内膜切除术的整体经验是迄今为止报道的最大系列之一。经批准的外科医生的数据完全在美国心脏协会卒中理事会推荐的可接受的神经系统发病率和死亡率范围内，这证明了参与研究的外科医生的整体质量。
Background and Purpose: The Asymptomatic Carotid Atherosclerosis Study is a prospective, multicenter, randomized clinical trial of carotid endarterectomy for the treatment of asymptomatic hemodynamically significant stenosis. This report describes the selection process for participating surgeons in the trial.Methods: The Surgical Management Committee established guidelines for minimal annual experience and maximum neurological morbidity and mortality for surgeons to qualify to participate in the study. For approval, a surgeon must perform at least 12 carotid endarterectomies per year. Based on a review of the surgeon's last 50 consecutive endarterectomies, the combined neurological morbidity and mortality rate must be no greater than 5% for all indications and no greater than 3% for endarterectomies performed on asymptomatic patients.Results: One hundred sixty-four surgeons from 48 centers applied for approval: 117 were approved, 17 were rejected, and 30 were not reviewed. The 117 approved surgeons submitted a total of 5,641 endarterectomies with a combined mortality and neurological morbidity rate of 2.3% for the variety of indications for operation.Conclusions: This overall experience with carotid endarterectomy is one of the largest series reported to date. The data from approved surgeons are well within the range of acceptable neurological morbidity and mortality rates recommended by the Stroke Council of the American Heart Association, which attests to the overall quality of the surgeons participating in the study.