BACKGROUND The International Carotid Stenting Study was a multicenter randomized trial in which patients with symptomatic carotid artery stenosis were randomly allocated to treatment by carotid stenting or endarterectomy. Economic evidence comparing these treatments is limited and inconsistent. AIMS We compared the cost-effectiveness of stenting versus endarterectomy using International Carot...

BACKGROUND AND PURPOSE The value of carotid endarterectomy in asymptomatic patients with high-grade stenosis is controversial. The objective of this study is to compare the immediate and long-term outcome of patients after carotid endarterectomy for asymptomatic carotid stenosis (greater than 75%) with the reported natural history of patients followed nonoperatively to determine whether carotid...

BACKGROUND Cerebrovascular disease is the third leading cause of death in the United States. The proportion of all strokes attributable to previously asymptomatic carotid artery stenosis (CAS) is low. In 1996, the U.S. Preventive Services Task Force concluded that evidence was insufficient to recommend for or against screening of asymptomatic persons for CAS by using physical examination or car...

BACKGROUND AND PURPOSE The benefit of carotid endarterectomy for preventing recurrent stroke is maximal when surgery is performed within 2 weeks after ischemic stroke or transient ischemic attack; the benefit is reduced when surgery is delayed >2 weeks and essentially lost if delayed >3 months. Guidelines recommend endarterectomy within 2 weeks poststroke/transient ischemic attack for patients ...

Two patients with transient ischemic attacks and subsequent minor cerebral infarction had repair of very tight carotid stenosis, 4 and 5 weeks respectively after their stroke. Each developed intracerebral hemorrhage when hypertension was uncontrolled during the post-operative period. Hypertension is a significant complication of carotid endarterectomy, and may be a prominent factor in the devel...

Cerebral hyperperfusion syndrome is a recognized complication of carotid endarterectomy. Various studies have documented an incidence of 0.3 to 1.2%. It occurs in the setting of sudden reperfusion of a chronically hypoperfused hemisphere. We present here a case of a 48-year-old lady who developed cerebral hyperperfusion syndrome three weeks after undergoing a carotid endarterectomy for high-gra...

Background and Purpose: The value of carotid endarterectomy in asymptomatic patients with high-grade stenosis is controversial. The objective of this study is to compare the immediate and long-term outcome of patients after carotid endarterectomy for asymptomatic carotid stenosis (>75%) with the reported natural history of patients followed nonoperatively to determine whether carotid endarterec...