Should people with asymptomatic carotid artery stenosis undergo endarterectomy for primary stroke prevention?
David J. Gladstone and Demetrios J. Sahlas Division of Neurology, Regional Stroke Centre, Sunnybrook and Women’s College Health Sciences Centre University of Toronto Toronto, Ont. Halliday A, Mansfield A, Marro J, Peto C, Peto R, Potter J, et al; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 2004;363: 1491-502. Background: Carotid endarterectomy (CE) is well established as a beneficial procedure for reducing the risk of stroke among patients with symptomatic high-grade carotid artery disease.1 However, its role in reducing the risk among patients with asymptomatic carotid artery stenosis (i.e., no prior cerebral or retinal transient ischemic attack [TIA] or stroke) has been less certain and the subject of much controversy.2 Design: This multicentre randomized trial is the world’s largest vascular surger
David J. Gladstone and Demetrios J. Sahlas Division of Neurology, Regional Stroke Centre, Sunnybrook and Women’s College Health Sciences Centre University of Toronto Toronto, Ont. Halliday A, Mansfield A, Marro J, Peto C, Peto R, Potter J, et al; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 2004;363: 1491-502. Background: Carotid endarterectomy (CE) is well established as a beneficial procedure for reducing the risk of stroke among patients with symptomatic high-grade carotid artery disease.1 However, its role in reducing the risk among patients with asymptomatic carotid artery stenosis (i.e., no prior cerebral or retinal transient ischemic attack [TIA] or stroke) has been less certain and the subject of much controversy.2 Design: This multicentre randomized trial is the world’s largest vascular surger
