Carotid Endarterectomy: Indications, Techniques, and Results

Carotid endarterectomy, introduced in the 1950s, has become the most frequently performed peripheral vascular surgical procedure in the United States. Several randomized prospective clinical trials have demonstrated the safety and efficacy of this procedure in the prevention of ischemic stroke in symptomatic and asymptomatic patients with significant internal carotid stenoses. The excellent perioperative results of this procedure reported in multicenter randomized clinical trials are being matched by the results reported in individual institutional series and in large population-based studies. Numerous studies have confirmed the long-term efficacy of carotid endarterectomy in terms of stroke prevention and anatomic durability.