Research clearly shows that carotid endarterectomy is more beneficial
than treatment with medicine if you have symptoms, such as a previous TIA or
mild stroke, and 70% or greater stenosis (narrowing).1
Most people in this category can significantly reduce their risk of
stroke by having an endarterectomy if they are otherwise healthy enough to
have surgery and they have a highly skilled surgeon who has a low
complication rate. A low complication rate means the surgeon has a small number
of patients who, because of the surgery, have a stroke or other
Research suggests that the surgeon doing the endarterectomy
should have a complication rate of no more than 6% for this procedure to be
considered beneficial for his or her patients. Complication rates higher than 6% negate the potential benefit of surgery. This means that you are
more likely to have complications from the surgery than to benefit from
long-term stroke risk reduction.2
To find your surgeon's complication rate, check with his or her
office, the hospital where the surgery will be done, and your state's
medical association. Access to this information may vary by state.
Another thing to think about is the hospital itself. Generally, larger
hospitals and regional medical centers have staffs that are more experienced in
doing carotid endarterectomies than those in smaller hospitals. Check to
see how many carotid endarterectomies are done in your hospital each year.
Rerkasem K, Rothwell PM (2011). Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database of Systematic Reviews (4).
Furie KL, et al (2011). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 42(1): 227–276. Also available online: http://stroke.ahajournals.org/content/42/1/227.full.
January 3, 2013
E. Gregory Thompson, MD - Internal Medicine
& Karin M. Lindholm, DO - Neurology
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