RESUMO
OBJECTIVE: To establish whether measures taken to shorten the interval of time between a stroke and carotid endarterectomy (CEA) procedure at two Dutch hospitals had any effect. DESIGN: Retrospective and descriptive. METHOD: Data were gathered on all patients with symptomatic narrowing of the carotid artery from a non-academic teaching hospital (Amphia Ziekenhuis in Breda) as well as from a university clinic dedicated to carotid abnormalities (University Medical Center Utrecht, UMCU). 'Pass-through' intervals were analysed from 2006 and 2007 and compared with those from 2010 when the sequence of hospital care had been improved in terms of time interval from stroke up to and including CEA. The time interval between the first symptoms of stroke and the first visit to the outpatient clinic specialist was determined, as well as the time interval between the stroke and CEA procedure. RESULTS: After the hospitals had taken measures to shorten the time interval between a stroke and an operation, the percentage of patients who had undergone surgery within 2 weeks in 2010 was 34% at Amphia Ziekenhuis and 21% at the UMCU, as opposed to 5.5% (2006) and 10.5% (2007), respectively. The median time between first symptoms and surgery had decreased from 40 to 19 days at Amphia Ziekenhuis and from 57 to 36 days at the UMCU. CONCLUSION: At both the non-academic clinic and the university centre dedicated to carotid abnormalities, the majority of symptomatic patients had not undergone surgery within 2 weeks of a stroke in 2010. A CEA must therefore become a semi-acute operation instead of a semi-elective one in order to meet its associated performance criteria in the near future.