Endarterectomy for Stenosis of Less Than 50% Without Symptoms

Research shows that there is no benefit to having endarterectomy if you have less than 50% stenosis (narrowing) and no symptoms, such as a previous TIA or mild stroke.^{Reference 1} People in this group do not benefit from endarterectomy and actually increase their risk of stroke or death from surgery because of complications of the procedure. For people with less than 50% stenosis who do not have symptoms, the American Heart Association guidelines recommend treatment with medications.^{Reference 2}

Since this group is already at a lower risk for stroke than those with a higher degree of stenosis, surgery would not likely further reduce that risk but would instead introduce new risks associated with surgery.

Citations

1. North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. New England Journal of Medicine, 325(7): 445–453.

2. Biller J, et al. (1998). Guidelines for carotid endarterectomy: A statement for healthcare professionals from a special writing group of the Stroke Council of the American Heart Association. Circulation, 97(5): 501–509.

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