Carotid endarterectomy was associated with a lower incidence of stroke (1.9% vs 16.2%) and recurrent TIA (17.6% vs 39.2%) compared to nonoperative treatment in hemodynamically significant stenosis.
Cohort (n=215)
Does carotid endarterectomy reduce stroke, recurrent TIA, and cerebrovascular death in patients with hemodynamically significant carotid stenosis compared to nonoperative treatment?
Carotid endarterectomy is associated with a substantially lower risk of stroke and recurrent TIA compared to nonoperative management in patients with hemodynamically significant carotid stenosis.
Absolute Event Rate: 1.9% vs 16.2%
Two hundred fifteen patients with a history of either stroke, transient ischemic attack (TIA), or asymptomatic carotid bruit underwent noninvasive carotid artery testing using oculopneumoplethysmography. Of patients with hemodynamically significant stenosis, 51 (40.8%) underwent endarterectomy, and 74 (59.2%) were treated nonoperatively. The incidence of stroke in the nonoperated group was 12/74 (16.2%) compared with only 1/51 (1.9%) in the operated group. Similarly, recurrent TIA occurred in 29/74 (39.2%) of the nonoperated group vs 9/51 (17.6%) of the operated. In nonhemodynamically significant carotid stenosis, the risk of cerebrovascular death and stroke was exceedingly low: 2/90 (2.2%). Patients with hemodynamically significant stenosis treated nonoperatively have a greater risk of cerebrovascular death, stroke, and TIA than patients treated with carotid endarterectomy. (JAMA1981;245:1438-1441)
Ronald W. Busuttil (1981) conducted a cohort in Carotid artery stenosis (n=215). Carotid endarterectomy vs. Nonoperative treatment was evaluated on Stroke. Carotid endarterectomy was associated with a lower incidence of stroke (1.9% vs 16.2%) and recurrent TIA (17.6% vs 39.2%) compared to nonoperative treatment in hemodynamically significant stenosis.