Current indications for carotid endarterectomy

Four randomized cooperative trials for asymptomatic carotid artery disease and three randomized cooperative trials of symptomatic carotid artery disease have been completed and published. There are now firm and proven indications for carotid artery reconstruction. Asymptomatic carotid artery disease with 60% or greater linear stenosis on angiography has been shown to be better treated with surgery than with medical therapy alone. For symptomatic patients, linear stenoses of 50% of greater have been shown to have a significant benefit with surgical treatment. All surgical recommendations are based on a morbidity/mortality of 3% or less for the individual surgeon.