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The surgical mortality of endarterectomy ranges from 1–2% to as much as 10%. Two large randomized clinical trials have demonstrated that carotid surgery done with a 30-day stroke and death risk of 3% or less will benefit asymptomatic people with ≥60% stenosis who are expected to live at least 5 years after surgery.
Carotid artery stenting is an endovascular procedure where a stent is deployed within the lumen of the carotid artery to treat narrowing of the carotid artery and decrease the risk of stroke. It is used to treat narrowing of the carotid artery in high-risk patients, when carotid endarterectomy is considered too risky.
Carotid endarterectomy: A carotid endarterectomy is a minimally invasive procedure to remove plaque from within your carotid artery, the main blood vessel that carries blood to your brain.
Carotid endarterectomy itself can cause strokes, so to be of benefit in preventing strokes over time, the risks for combined 30-day mortality and stroke risk following surgery should be < 3% for asymptomatic people and ≤ 6% for symptomatic people. [1] The carotid artery is the large vertical artery in red.
Carotid artery stenosis can be treated with angioplasty and carotid stenting for patients at high risk for undergoing carotid endarterectomy. [11] Although carotid endarterectomy is typically preferred over carotid artery stenting, stenting is indicated in select patients with radiation-induced stenosis or a carotid lesion not suitable for surgery.
Carotid artery disease can be typically addressed with open surgical techniques (carotid endarterectomy) or though endovascular stenting. Chronic mesenteric ischemia can produce severe pain with eating and result in food fear and weight loss. These vascular disorders can be repaired by endovascular approaches using angioplasty and stenting.
On the basis of this study and the work on plaque characterisation it has become possible to identify a high risk group of patients with asymptomatic carotid stenosis (5.5% stroke rate per year), but most important has been the identification of a low risk group with an annual stroke risk of less than 1%, that can be spared from unnecessary ...
[8] [9] [10] Even without causing a stroke, carotid stenosis leads to chronic disabilities that impact quality of life. Since carotid blockages affect 5 – 10% of all older adults, these newly discovered problems affect a large and vulnerable group of people. He delivered the Clemens Lecture at Yale School of Medicine on this topic. [11]