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  • Title: [Indications for endarterectomy in asymptomatic stenoses of the internal or common carotid artery--results of the North American ACAS Study].
    Author: Mast H, Chambless LE, Mohr JP, Toole JF.
    Journal: Zentralbl Chir; 1996; 121(12):1033-5. PubMed ID: 9092223.
    Abstract:
    OBJECTIVE: To determine the effect of endarterectomy on the primary prevention of ischemic stroke in patients with asymptomatic carotid artery stenosis. METHODS: In a prospective, randomized, multicenter trial 1659 patients with asymptomatic carotid stenosis of 60% or more were studied in two treatment arms (endarterectomy: n = 825; medical therapy: n = 834). Endpoints were: (1) ischemic stroke in the vascular territory of the study artery, (2) any perioperative stroke or any perioperative death. RESULTS: The Kaplan-Meier 5-year-risk estimation showed a relative risk reduction of 53% (confidence interval: 22%-72%) for patients in the surgical arm. The combined perioperative morbidity and mortality rate was 2.3%. CONCLUSION: Endarterectomy of asymptomatic carotid artery stenosis performed with a perioperative complication rate of less than 3% reduces the 5-year risk of ipsilateral stroke.
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