Key result
Carotid endarterectomy cuts stroke or operative death ~47% in symptomatic severe stenosis without near-occlusion.
Why the study?
Does carotid endarterectomy reduce stroke or operative death in participants with symptomatic carotid stenosis?
Systematic Review (n=4,344)
Does carotid endarterectomy reduce stroke or operative death in participants with symptomatic carotid stenosis?
Effect estimate: RR 0.53 (95% CI 0.42 to 0.67)
Carotid endarterectomy is highly beneficial for symptomatic patients with 70% to 99% carotid stenosis without near-occlusion and moderately beneficial for 50% to 69% stenosis, but lacks significant benefit for <50% stenosis or near-occlusions.
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Supports CEA for symptomatic 70-99% stenosis without near-occlusion; reinforces Level 1 evidence for guideline-directed intervention.
Rerkasem et al. (2020) conducted a systematic review in Symptomatic carotid stenosis (n=4,344). Carotid endarterectomy was evaluated on Any stroke or operative death (RR 0.53, 95% CI 0.42 to 0.67). Carotid endarterectomy was highly beneficial for reducing stroke or operative death in symptomatic patients with 70% to 99% stenosis without near-occlusion (RR 0.53; 95% CI 0.42 to 0.67).
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