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What are the indications for surgical carotid endarterectomy (CEA)?
Several studies involving large numbers of patients demonstrate that CEA reduces the risk of stroke in patients with critical carotid artery stenosis. Two large-scale studies show that symptomatic patients with greater than 70% luminal narrowing of the carotid artery had improved out-come after surgery when compared with patients receiving medical treatment alone. Symptoms included transient ischemic attack (TIA), reversible ischemic neurologic deficit, and nondisabling stroke.
For asymptomatic patients with greater than 60% lumi-nal narrowing, CEA decreased the incidence of stroke at 5 years compared with patients treated medically.
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