Is Carotid Endarterectomy Beneficial in Prevention of Recurrent Stroke?

Joshua A. Bardin, MD; Eugene F. Bernstein, MD, PhD; Phillip B. Humber, MD; Geoffrey M. Collins, MD; Ralph B. Dilley, MD; Joseph B. Devin, MD; Susan H. Stuart, MSE
Arch Surg. 1982;117(11):1401-1407. doi:10.1001/archsurg.1982.01380350009002.
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• Of 456 consecutive carotid endarterectomies performed at the University of California, San Diego, 127 were in patients who had sustained a previous completed stroke and had recovered with minimal but permanent neurologic deficits (PNDs). Operative mortality for the entire series was 0.9%, but it was 3.1% for the stroke group. A postoperative PND was observed in 2.1% of patients without neurologic deficits but occurred in 3.9% of the patients after stroke. A 97% one- to ten-year follow-up was obtained. The total early and late serious morbidity and mortality in this surgically treated series of patients after stroke was 24% at five years. We conclude that carotid endarterectomy for the prevention of recurrent stroke carries a high risk and may not be superior to nonoperative treatment.

(Arch Surg 1982;117:1401-1407)


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