quarta-feira, agosto 03, 2011


A Systematic Review of Randomized Controlled Trials of
Carotid Endarterectomy for Symptomatic Carotid Stenosis
Kittipan Rerkasem, MD, PhD; Peter M. Rothwell, MD, PhD, FRCP, FMedSci
Stroke published online July 28, 2011
Endarterectomy is of some benefit for 50% to 69% symptomatic stenosis and highly beneficial for 70% to 99%stenosis without near occlusion. Benefit in patients with carotid near occlusion is marginal in the short term and uncertain in the long term. These results are generalizable
only to surgically fit patients operated on by surgeons with low complication rates ( 7% risk of stroke and death).
Benefit from endarterectomy depends not only on the degree of carotid stenosis, but also on several other factors, including the delay to surgery after the presenting event. In particular,
in patients with only 50% to 69% stenosis, there was no evidence of benefit in women and little evidence of benefit if surgery was delayed by 2 weeks after the presenting event


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