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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.
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.
Carotid endarterectomy: A carotid endarterectomy is a minimally invasive procedure to remove plaque from within your carotid artery, the main blood vessel that carries blood to your brain.
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]
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 stenting is an endovascular procedure where a stent is deployed within the lumen of the carotid artery to treat narrowing of the carotid artery and decrease the risk of stroke. It is used to treat narrowing of the carotid artery in high-risk patients, when carotid endarterectomy is considered too risky.
Carotid artery stenosis can be treated with angioplasty and carotid stenting for patients at high risk for undergoing carotid endarterectomy. [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 for ...
Carotid artery stenosis is a major risk factor for stroke, and risk assessment of atherosclerotic carotid plaques is a critical component of stroke prevention. Advances in imaging have allowed for risk stratification including degree of stenosis and how vulnerable the atherosclerotic plaque is to rupture.