How does the prognosis of atherosclerotic disease of the carotid artery vary between surgically and medically managed patients?

Updated: Sep 29, 2021
  • Author: Jake F Hemingway, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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In the North American Symptomatic Carotid Endarterectomy Trial (NASCET), the 2-year stroke risk after a successful carotid endarterectomy (CEA) was 1.6%, compared with 12.2% for the medically managed patients. [1] The cumulative risk of an ipsilateral stroke was 9% for the surgical patients and 26% for the medically managed patients.

In the Asymptomatic Carotid Atherosclerosis Study (ACAS), the 5-year risk for ipsilateral stroke was 5.1% for the surgical group and 11% for the medical group. [3] The stroke risk of arteriography was attributed to the surgical group and was 1.2%.

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