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Carotid Endarterectomy: A Challenge for Scientific Medicine

  • H. J. M. Barnett

Abstract

Carotid endarterectomy (CE) was introduced very shortly after cerebral angiography identified the extracranial portion of the carotid artery as a common site responsible for stroke-threatening transient ischemic attacks (TIA). On the face of it, it was, and to many remains, as logical a surgical activity as the removal of an acoustic neuroma or the clipping of a saccular intracranial aneurysm. Why, then, has the procedure fallen afoul of universal acceptance? The reasons are several:
  1. 1.

    In the case of a ruptured aneurysm, the mortality, let alone the morbidity, from a recurrent hemorrhage is close to 50%. The survivors have almost an equal chance of being left with a serious disability. The TIA patient has at least a 90% chance of going through each successive year after the initial event(s) without a serious outcome.

     
  2. 2.

    If a stroke does occur, there is at least a 30% chance of its being in another arterial territory from that of the artery that caused the presenting symptoms.

     

Keywords

Carotid Endarterectomy Acoustic Neuroma Transient Cerebral Ischemia North American Symptomatic Carotid Endarterectomy Trial Asymptomatic Carotid Stenosis 
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

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • H. J. M. Barnett

There are no affiliations available

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