Carotid EndarterectomyACAS

• Asymptomatic Carotid Artery Stenosis Trial

  • 1,662 pts at 39 centers with stenosis > 60%
  • Benefit was greater in men
  • Results depended on surgeon with < 3% m & m
  • Perioperative morbidity & mortality was 2.4%
  • 1.2% complication rate related to cerebral angiography

5-Year Risk of Ipsilateral

Stroke & Stroke Death

P<0.004

Risk of Stroke in patients

followed medically with tight

Carotid stenosis is 2-5% per year

55% Risk

Reduction

Over 5-years

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