Comparing the Surgical Outcomes of Carotid Endarterectomy: Assessing the Impact of Consultant versus Trainee Cases on Patient Care and Surgical Training.

Background: This study assesses the impact of having a surgical trainee performing a carotid endarterectomy (CEA) procedure on the postoperative rates of stroke and death.

Methods: In this observational retrospective study, consecutive patients, who underwent CEA between May 01, 2016, and July 31, 2022, were entered into a retrospectively collected database. Patients were stratified into 2 categories - consultant-led cases and trainees-led cases. Primary outcomes were 30-day stroke rate, and 30-day morbimortality. A sub analysis was performed after grouping the patients in whether there was a neurological event in the previous 6 months - symptomatic or asymptomatic.

Results/conclusions: Trainees-led cases had significantly longer clamping times and higher rates of stroke in asymptomatic patients compared with consultant-led cases. Patient's safety should be our top priority. Any practice leading to a significantly increased rate of postoperative stroke must be discontinued. Training protocols and adequate supervision must ensure that trainees possess the necessary skills and knowledge to safely and effectively perform CEA procedures, thereby prioritizing patient safety.