Medical compared with surgical treatment of asymptomatic carotid artery stenosis

Thomas G Brott, J. F. Toole

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

The Asymptomatic Carotid Atherosclerosis Study (ACAS) results suggest that carotid endarterectomy combined with aspirin and risk factor reduction is superior to aspirin and risk factor reduction alone in preventing ipsilateral stroke in asymptomatic patients with diameter stenosis of the carotid artery of 60% or more. The absolute risk reduction over 5 years conferred by surgical therapy is modest (5.9%) compared with the risk reduction conferred by surgical therapy for symptomatic carotid disease but compares favorably with the degree of stroke prevention shown for antihypertensive therapy in the elderly. For prevention of stroke in women and for prevention of major stroke, the ACAS results favoring surgery did not reach statistical significance. The combined arteriographic and perioperative surgery-related mortality and stroke rates achieved by the carefully selected surgical teams was low (2.3%). Accordingly, carotid endarterectomy can be recommended for preventing stroke in the setting of hemodynamically significant stenosis when the arteriographic and surgical complication rates can be kept low.

Original languageEnglish (US)
Pages (from-to)720-722
Number of pages3
JournalAnnals of Internal Medicine
Volume123
Issue number9
StatePublished - 1995
Externally publishedYes

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Carotid Stenosis
Stroke
Risk Reduction Behavior
Carotid Artery Diseases
Carotid Endarterectomy
Aspirin
Therapeutics
Numbers Needed To Treat
Antihypertensive Agents
Pathologic Constriction
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Medical compared with surgical treatment of asymptomatic carotid artery stenosis. / Brott, Thomas G; Toole, J. F.

In: Annals of Internal Medicine, Vol. 123, No. 9, 1995, p. 720-722.

Research output: Contribution to journalArticle

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