Seventy-nine carotid endarterecto mies were performed for 65 patients in a 140-bed hospital in a predominantly rural community during a 5-year pe riod. The procedure's mortality was 3.8%, and the rate of surgical stroke was 3.8%. In a small community hospital where most assistants have relatively limited experience in vascular surgical procedure, it was felt advisable to use the internal shunt routinely.
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