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Journal List > West J Med > v.159(1); Jul 1993

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West J Med. 1993 July; 159(1): 37–43.
PMCID: PMC1022156
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Carotid endarterectomy for prevention of stroke.
W S Moore
Section of Vascular Surgery, University of California, Los Angeles, School of Medicine.
Small right arrow pointing to: See commentary "Carotid endarterectomy--the big picture." on page 90.
 
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Abstract
Carotid endarterectomy, a frequently performed operation, has been used as a strategy for preventing stroke in patients with carotid bifurcation disease. The safety and efficacy of the operation were recently challenged by a number of sources. Three major responses to this challenge were to retrospectively review the natural history of carotid bifurcation disease compared with the immediate and long-term results of carotid endarterectomy, to initiate 6 prospective randomized trials to determine the efficacy of carotid endarterectomy for a variety of indications, and to develop appropriateness initiatives and guidelines for using this surgical procedure by organizations concerned with health care policy. I review the current status of these 3 areas of endeavor. In those areas where studies are complete, carotid endarterectomy has been shown to be highly effective in reducing stroke risk. Risk reduction has ranged from 66% to 80% compared with medical management. Based on these sources and findings, I present a list of indications for the operation for surgeons who are able to do the operation safely and within the guidelines established by the Stroke Council of the American Heart Association.
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
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