Carotid endarterectomy without angiography: a prospective randomised pilot study.

OBJECTIVES to determine whether duplex ultrasonography alone is an adequate examination prior to carotid endarterectomy. DESIGN prospective, randomised, single centre study. MATERIAL AND METHODS all patients with carotid bifurcation stenosis greater than 70% - based on duplex scanning - were randomised to arteriography followed by carotid surgery (Group A n=96) or carotid surgery alone (Group B n=90). Study endpoints were neurological complications or death occurring between the day of randomisation and until 30 days after surgery. RESULTS major neurological complications of death in 1 (1%) vs 3 (3.3%) patients in group A and B, respectively (n.s.). Minor neurological complications (only TIA) were observed in 0 and 3 (3.3%) patients, respectively. CONCLUSIONS complication rates were low in both groups and within the generally accepted rate after carotid surgery in asymptomatic and symptomatic patients.