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).
Systematic Review (n=4,344)
Does carotid endarterectomy reduce stroke or operative death in participants with symptomatic carotid stenosis?
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.
Effect estimate: RR 0.53 (95% CI 0.42 to 0.67)
Cochrane Database of Systematic Reviews stroke or operative death in participants with 30% to 49% stenosis (RR 0.97, 95% CI 0.79 to 1.19; 2 studies, 1429 participants; high-quality evidence), was of benefit in participants with 50% to 69% stenosis (RR 0.77, 95% CI 0.63 to 0.94; 3 studies, 1549 participants; moderatequality evidence), and was highly beneficial in participants with 70% to 99% stenosis without near-occlusion (RR 0.53, 95% CI 0.42 to 0.67; 3 studies, 1095 participants; moderate-quality evidence). However, surgery decreased the five-year risk of any stroke or operative death in participants with near-occlusions (RR 0.95, 95% CI 0.59 to 1.53; 2 studies, 271 participants; moderate-quality evidence).
Rerkasem et al. (Sat,) 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).