Background

Stroke is a leading cause of morbidity and mortality in the US with 500,000 cases each year and 200,000 of these dying as a result. Carotid endarterectomy (CEA) serves to reduce the risk of stroke and has been found to do this better than medical management alone. The first CEA was performed by DeBakey in 1953 and since that time, the utility of carotid endarterectomy (CEA) has been well documented by a series of randomized controlled studies. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) is probably the most significant carotid study to date. It showed a decrease in stroke rate from 26% to 9% with CEA compared to medical management alone (Table 18.1).

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