In Asymptomatic Carotid Stenosis, Endarterectomy Prevents Strokes for at Least 10 Years

In patients with asymptomatic moderate-to-severe carotid artery stenosis, endarterectomy lowers long-term risk for stroke but carries substantial risk for perioperative stroke or death. In one study, started in 1993, investigators randomized 3120 such patients to immediate endarterectomy or no immediate intervention (with the option to elect endarterectomy at any time and for any reason). In a 2004 report from this international group, immediate endarterectomy carried a 3% perioperative risk for stroke or death, and the 5-year risk for nonperioperative stroke was significantly lower in the endarterectomy group than in the deferred-intervention group (3.8% vs. 11.0%) (JW Gen Med May 21 2004).

Investigators now report on these patients 5 years…