Another Major Trial of Endarterectomy for Asymptomatic Carotid Stenosis

Surgery reduced the 5-year risk for stroke in asymptomatic patients with ≥60% carotid stenosis.

In a 1995 North American randomized trial of patients with asymptomatic carotid stenosis of 60% or more, 5-year risk for ipsilateral stroke was lower with carotid endarterectomy (CEA) than with medical management (5% vs. 11%; Journal Watch May 16 1995). Now, in a similar European randomized trial, 3120 patients with ultrasound-detected carotid stenosis of at least 60% and no related symptoms within the previous 6 months underwent CEA or received nonsurgical treatment.

The rate of stroke or death within 30 days of CEA was 3.1%. Estimated 5-year risk for any stroke (plus any perioperative stroke or death) was significantly lower in the CEA group than in the nonsurgical group (6.4% vs. 11.8%). For disabling or fatal strokes only, the difference…

Reviewing Author

Allan S. Brett, MD