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Annals of Vascular Surgery

, Volume 8, Issue 2, pp 144–149 | Cite as

Immediate and long-term results of carotid endarterectomy for asymptomatic high-grade stenosis

  • Thomas S. Riles
  • Frederick S. Fisher
  • Patrick J. Lamparello
  • Gary Giangola
  • Lee Gibstein
  • Ronnie Mintzer
  • William T. Su
Original Articles

Abstract

We examined the operative risks and long-term results of carotid endarterectomy for asymptomatic patients in terms of stroke, death, and recurrent stenosis. The results of a nonrandomized study with a follow-up of 1 to 104 months (mean 46 months) is reported. A tertiary referral center served as the setting for this report. One hundred consecutive patients with severe but asymptomatic carotid artery stenosis out of a total of 514 patients undergoing carotid endarterectomy were entered into this study. The severity of carotid disease was determined by duplex scanning and confirmed arteriographically. No patients were lost to follow-up after surgery. Eighty-nine operations (77%) were done under cervical block anesthesia and all arteries were closed with saphenous vein patches. Life-table analysis showed that the stroke-free rate at 5 years was 96.3% with an ipsilateral stroke-free rate of 98.2%. The 5-year overall survival rate was 78.2% with a stroke-free survival rate of 75%. Carotid endarterectomy can be performed safely for asymptomatic patients believed to be at risk for stroke. The potential for early death due to myocardial disease, late stroke, and recurrent stenosis do not justify advising patients against undergoing prophylactic carotid endarterectomy for asymptomatic high-grade stenosis.

Keywords

Asymptomatic Patient Saphenous Vein Carotid Endarterectomy Tertiary Referral Center Asymptomatic Carotid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Annals of Vascular Surgery Inc. 1994

Authors and Affiliations

  • Thomas S. Riles
    • 1
  • Frederick S. Fisher
    • 1
  • Patrick J. Lamparello
    • 1
  • Gary Giangola
    • 1
  • Lee Gibstein
    • 1
  • Ronnie Mintzer
    • 1
  • William T. Su
    • 1
  1. 1.Department of SurgeryNew York University Medical CenterNew York

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