Lower 10-Year Incidence of Stroke After Endarterectomy

Successful carotid endarterectomy reduces 10-year stroke risks in asymptomatic patients, a Lancet study finds.

In an international study, researchers randomized 3100 asymptomatic patients with at least 60% stenosis either to immediate endarterectomy or to indefinite deferral of any procedure. In the 30-day perioperative period, the risk for stroke or death was 3%.

When perioperative events and non-stroke deaths were excluded, patients undergoing immediate endarterectomy had lower stroke risks at 5 and 10 years. When the perioperative risks were included, net stroke risks were still lower at 10 years (13% vs. 18%).

Commentators write that the results "confirm the superiority of immediate [endarterectomy] versus medical therapy," and they conclude that endarterectomy "remains the first choice of revascularization therapy for an asymptomatic carotid lesion."

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