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Stroke. 2003;34:2941-2944
Published online before print November 13, 2003, doi: 10.1161/01.STR.0000098903.93992.49
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(Stroke. 2003;34:2941.)
© 2003 American Heart Association, Inc.

Original Contributions

Durability of Carotid Endarterectomy

Robert D. Ecker, MD; Mark A. Pichelmann, MD; Irene Meissner, MD Fredric B. Meyer, MD

From the Departments of Neurosurgery (R.D.E., M.A.P., F.B.M.) and Neurology (I.M.), Mayo Clinic and Foundation, Rochester, Minn.

Correspondence to Fredric B. Meyer, MD, Department of Neurosurgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail meyer.fredric{at}mayo.edu

Background and Purpose— We sought to determine the incidence of recurrent stenosis after carotid endarterectomy.

Methods— One thousand consecutive carotid endarterectomy patients were followed prospectively. The surgery was performed in a standard fashion. Cerebral protection was provided with intraoperative electroencephalographic monitoring and selective shunting. All arteriotomies were repaired with a patch graft. Each patient was seen 3 months after surgery and then yearly, with a duplex ultrasound obtained at each visit. Evidence for new ischemic events or recurrent stenosis of >=70% was recorded.

Results— The 30-day combined minor and major stroke and death rate was 1.9%. At 7.1-year follow-up, 0.1% of patients had recurrent stenosis >=70%, the majority of which were asymptomatic.

Conclusions— Carotid endarterectomy is a low-risk procedure for the treatment of carotid occlusive disease, with excellent long-term durability. Although less invasive, carotid angioplasty must demonstrate equal robustness in long-term follow-up before it is considered a routine alternative to surgery.


Key Words: carotid endarterectomy • stenosis • stroke




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