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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