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Carotid endarterectomy is used to reduce the risk of strokes caused by carotid artery stenosis over time. Carotid stenosis can either have symptoms (i.e., be symptomatic), or be found by a doctor in the absence of symptoms (asymptomatic) - and the risk-reduction from endarterectomy is greater for symptomatic than asymptomatic patients.
Atherosclerotic plaque from a carotid endarterectomy specimen. An endarterectomy of the carotid artery in the neck is recommended to reduce the risk of stroke when the carotid artery is severely narrowed, particularly after a stroke to reduce the risk of additional strokes. [citation needed]
The surgical mortality of endarterectomy ranges from 1–2% to as much as 10%. Two large randomized clinical trials have demonstrated that carotid surgery done with a 30-day stroke and death risk of 3% or less will benefit asymptomatic people with ≥60% stenosis who are expected to live at least 5 years after surgery.
North American Symptomatic Carotid Endarterectomy Trial (NASCET) 1415: Showed carotid endarterectomy was beneficial in symptomatic patients. Two year stroke rate in patients with > 70% carotid stenosis decreased from 26% to 9%. Two year stroke rate in patients with > 50% decreased from 15% to 9%. [42] [43] Asymptomatic Carotid Atherosclerosis ...
Carotid artery stenosis can be treated with angioplasty and carotid stenting for patients at high risk for undergoing carotid endarterectomy (CEA). [11] Although carotid endarterectomy is typically preferred over carotid artery stenting, stenting is indicated in select patients with radiation-induced stenosis or a carotid lesion not suitable ...
In cases where a significant artery is totally blocked, it may be possible to remove the plaque and use the same hole in the artery to perform an anastomosis. This technique is called endarterectomy and is usually performed at the right coronary system. [26] Re-operations of CABG (another CABG operation after a previous one) pose difficulties.
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