Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: Randomised controlled trial

Abstract

Background Among patients with substantial carotid artery narrowing but no recent neurological symptom (stroke or transient ischaemia), the balance of surgical risks and longterm benefits from carotid endarterectomy (CEA) was unclear. Methods During 1993-2003, 3120 asymptomatic patients with substantial carotid narrowing were randomised equally between immediate CEA (half got CEA by 1 month, 88% by 1 year) and indefinite deferral of any CEA (only 4% per year got CEA) and were followed for up to 5 years (mean 3·4 years). Kaplan-Meier analyses of 5-year risks are by allocated treatment. Findings The risk of stroke or death within 30 days of CEA was 3·1% (95% CI 2·3-4·1). Comparing all patients..