North american symptomatic carotid endarterectomy trial

Background Citations. Methods Citations. Topics from this paper. Carotid Endarterectomy Cerebrovascular accident. Cessation of life Exclusion.

Rule guideline. Citation Type. Has PDF. Results are available for patients in the group with the most severe stenoses. Despite higher perioperative morbidity in the presence of an occluded contralateral artery, the longer-term outlook for patients who had endarterectomy performed on the recently symptomatic, severely stenosed ipsilateral carotid artery was considerably better than for medically treated patients. Description: Carotid endarterectomy for stroke and death in symptomatic patients.

Hypothesis: Carotid endarterectomy may reduce the risk of stroke and stroke-related death. Exclusions: Not competent to give informed consent because of repetitive language difficulty, intellectual decline, or psychiatric illness. Primary Endpoints: Fatal or nonfatal stroke ipsilateral to the carotid lesion.

Methods: The rates of perioperative stroke and death at 30 days and the final assessment of stroke severity at 90 days were calculated. Regression modeling was used to identify variables that increased or decreased perioperative risk. Nonoutcome surgical complications were summarized. The durability of carotid endarterectomy was examined. Patients eligible for the trial, but not randomized totaled 1,; their characteristics were similar to those randomized so that, for the type of symptomatic patient in this study, our conclusions about the benefit of carotid endarterectomy can be generalized.

Patients excluded by medical criteria totaled Another 1, had carotid endarterectomy, but either lacked the disease under study, were asymptomatic, or received inadequate investigation to meet entry criteria.