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Carotid Endarterectomy: A Challenge for Scientific Medicine

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Prevention of Stroke

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Abstract

Carotid endarterectomy (CE) was introduced very shortly after cerebral angiography identified the extracranial portion of the carotid artery as a common site responsible for stroke-threatening transient ischemic attacks (TIA). On the face of it, it was, and to many remains, as logical a surgical activity as the removal of an acoustic neuroma or the clipping of a saccular intracranial aneurysm. Why, then, has the procedure fallen afoul of universal acceptance? The reasons are several:

  1. 1.

    In the case of a ruptured aneurysm, the mortality, let alone the morbidity, from a recurrent hemorrhage is close to 50%. The survivors have almost an equal chance of being left with a serious disability. The TIA patient has at least a 90% chance of going through each successive year after the initial event(s) without a serious outcome.

  2. 2.

    If a stroke does occur, there is at least a 30% chance of its being in another arterial territory from that of the artery that caused the presenting symptoms.

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Authors
  1. H. J. M. Barnett
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Editors and Affiliations

  1. Department of Neurology, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, M4N 3M5, Canada

    John W. Norris M.D.

  2. Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, N6A 5A5, Canada

    Vladimir C. Hachinski M.D.

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© 1991 Springer Science+Business Media New York

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Barnett, H.J.M. (1991). Carotid Endarterectomy: A Challenge for Scientific Medicine. In: Norris, J.W., Hachinski, V.C. (eds) Prevention of Stroke. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4226-8_14

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  • DOI: https://doi.org/10.1007/978-1-4757-4226-8_14

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-4228-2

  • Online ISBN: 978-1-4757-4226-8

  • eBook Packages: Springer Book Archive

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