November 1982

Is Carotid Endarterectomy Beneficial in Prevention of Recurrent Stroke?

Author Affiliations

From the Department of Surgery, University of California School of Medicine at San Diego (Drs Bardin, Humber, and Collins and Ms Stuart), the Department of Surgery, Scripps Clinic and Research Foundation (Drs Bernstein and Dilley), and the Department of Surgery, Veterans Administration Hospital (Drs Bardin, Humber, Collins, and Devin and Ms Stuart), La Jolla, Calif.

Arch Surg. 1982;117(11):1401-1407. doi:10.1001/archsurg.1982.01380350009002

• 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)