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In Search of a Worthy Alternative to Endarterectomy

Robert D. G. Ferguson, MD; John G. Ferguson, MD

Arch Neurol. 1996;53(7):696-698.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CAROTID endarterectomy is beneficial in selected patients with carotid atherosclerosis^1-4; however, it has incontrovertible limitations. Carotid angioplasty is a potential alternative to surgical revascularization. Although angioplasty has not been submitted to a definitive clinical test, its potential advantages warrant evaluation.

Despite its beneficial overall effect in the controlled setting of clinical trials, endarterectomy's risk of death and stroke preclude surgery in some patients.⁵ The North American Symptomatic Carotid Endarterectomy Trial Collaborators¹ and Veterans Affairs³ trial posted a perioperative death and/or stroke rate of 5.8% and 6.7%, respectively, despite excluding surgeons whose pretrial endarterectomy complication rates exceeded 6%. Conversely, the European Carotid Surgery Trialists' Collaborative Group² did not explicitly limit surgeon participation based on complication rates and had a rate of 7.5% for the same end point. Contemporary communitybased audits,^6-8 which may be more representative of actual health care delivery, suggest that disability and death from carotid . . . [Full Text PDF of this Article]

Author Affiliations
From the Memphis Vascular Research Foundation, Memphis, Tenn.

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