Surgical Treatment of Atherosclerotic Extracranial Lesions

Is There an Indication for Carotid Endarterectomy?
  • Sydney J. Peerless
  • Henry J. M. Barnett
Conference paper


The most common disease of the brain causing death, serious disability, and prolonged suffering is ischemic stroke. Although the incidence of ischemic stroke has declined markedly in the past 30 years, the prevention of stroke continues to be a major concern of neurologists, neurosurgeons, and, indeed, the whole medical community.


Carotid Endarterectomy Carotid Stenosis Transient Cerebral Ischemia Carotid Artery Lesion Carotid Endarte 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Acheson J, Hutchinson EC (1964) Observations of the natural history of transient cerebral ischemia. Lancet II: 871–874CrossRefGoogle Scholar
  2. 2.
    Allen GS, Preziosi TJ (1981) Carotid endarterectomy: A prospective study of its efficacy and safety. Medicine 60:298–309PubMedCrossRefGoogle Scholar
  3. 3.
    Anderson GI, Whisnant JP (1982) A comparison of trends in mortality from stroke in the United States and Rochester, Minnesota. Stroke 13:804–809PubMedCrossRefGoogle Scholar
  4. 4.
    Baker RN, Ramseyer JC, Schwartz WF (1968) Prognosis in patients with transient cerebral ischemia. Neurology 18:1156–1165Google Scholar
  5. 5.
    Barnett HJM (1979) The Canadian Cooperative Study of platelet-suppressive drugs in transient cerebral ischemia. In: Price TR, Nelson E (eds). Cerebral diseases. Raven, New York, pp 211–236Google Scholar
  6. 6.
    Bousser MG, Eschwege E, Haguenau M, et al. (1983) “AICLA” controlled trial of aspirin and dipyridamole in the secondary prevention of athero-thrombotic cerebral ischemia. Stroke 14:5PubMedCrossRefGoogle Scholar
  7. 7.
    De Weese JA, Rob CG, Satran R, et al. (1971) Endarterectomy for atherosclerotic lesions of the carotid artery. J Cardiovasc Surg 12:299–308Google Scholar
  8. 8.
    Dixon S, Pais SO, Raviola C, et al. (1982) Natural history of nonstenotic asymptomatic ulcerative lesions of the carotid artery. Arch Sur 117:1493–1497CrossRefGoogle Scholar
  9. 9.
    Donnon GA, Bladin PF (1979) The stroke syndrome of long intraluminal clot with incomplete vessel occlusion: Clinical and experimental. Neurology 16:41–47Google Scholar
  10. 10.
    Dyken M (1986) Personal communicationGoogle Scholar
  11. 11.
    Dyken ML, Calhoun RA (1983) Changes in stroke mortality: Effects on evaluating and predicting outcome for therapeutic studies. In: Reivich M, Hurtig HI (eds) Cerebrovascular diseases. Raven, New York, pp 51–55Google Scholar
  12. 12.
    Dyken ML, Pokras R (1984) The performance of endarterectomy for disease of the extracranial arteries of the head. Stroke 15:948–950PubMedCrossRefGoogle Scholar
  13. 13.
    Easton JD, Sherman DG (1977) Stroke and mortality rate in carotid endarterectomy: 228 consecutive operations. Stroke 8:565–568PubMedCrossRefGoogle Scholar
  14. 14.
    Fields WS, Lemak NA, Frankowski RF, Hardy RJ (1977) Controlled trial of aspirin in cerebral ischemia. Stroke 8:301PubMedCrossRefGoogle Scholar
  15. 15.
    Fields WS, Maslenkiov V, Meyer JS, et al. (1970) Joint study of extracranial arterial occlusion: V. Progress report of prognosis following surgery or non-surgical treatment for transient cerebral ischemic attacks and cervical carotid artery lesions. JAMA 211:1993–2003PubMedCrossRefGoogle Scholar
  16. 16.
    Fleming JFR, Griesdale DE, Schutz H, Hogan M (1977) Carotid endarterectomy: Changing morbidity and mortality. Stroke 8:14Google Scholar
  17. 17.
    Fode NC, Sundt TM, Robertson JT, et al. (1986) Multicenter retrospective review of results and complications of carotid endarterectomy in 1981. Stroke 17:370–376PubMedCrossRefGoogle Scholar
  18. 18.
    Gates PC, Buchan AM, Barnett HJM (1985) Luminal thrombus in the cerebral circulation. Stroke 16:140Google Scholar
  19. 19.
    Harrison MJG, Marshall J (1982) Prognostic significance of severity of carotid atheroma in early manifestations of cerebrovascular disease. Stroke 13:567–569PubMedCrossRefGoogle Scholar
  20. 20.
    Harward IRD, Kroener JM, Wickbom IG, Bernstein EF (1983) Natural history of asymptomatic ulcerative plaques of the carotid bifurcation. Am J Surg 146:208–212PubMedCrossRefGoogle Scholar
  21. 21.
    Kannel WB, Wolf PA (1983) Epidemiology of cerebrovascular diseases. In: Russell RW (ed) Cerebral arterial disease, 2nd edn. Churchill-Livingstone, EdinburghGoogle Scholar
  22. 22.
    Lauzier S, Cote R, Ogunyemi A, et al. (1986) Predictive value of cerebral atheroma in 158 patients—a ten year follow-up. Stroke 17:5Google Scholar
  23. 23.
    Marshall J (1964) The natural history of transient ischemic cerebrovascular attacks. Quart J Med 33:309–324PubMedGoogle Scholar
  24. 24.
    Matsumoto N, Whisnant JP, Kurland LT, Okazaki H (1973) Natural history of stroke in Rochester, Minnesota, 1955 through 1969: An extension of a previous study, 1945 through 1954. Stroke 4:20–29PubMedCrossRefGoogle Scholar
  25. 25.
    Moore WS, Boren C, Malone JM, et al. (1978) Natural history of nonstenotic asymptomatic ulcerative lesions of the carotid artery. Arch Surg 113:1352PubMedCrossRefGoogle Scholar
  26. 26.
    Nunn DB (1975) Carotid endarterectomy: An analysis of 234 operative cases. Ann Surg 182:733–738PubMedCrossRefGoogle Scholar
  27. 27.
    Roederer GO, Langlois YE, Jager KA, et al. (1984) The natural history of carotid arterial disease in asymptomatic patients with cervical bruits. Stroke 15:605PubMedCrossRefGoogle Scholar
  28. 28.
    Shaw DA, Venables GS, Cartlidge NEF, et al. (1984) Carotid endarterectomy in patients with transient cerebral ischemia. J Neurol Sci 64:45–53PubMedCrossRefGoogle Scholar
  29. 29.
    Sundt TM, Sharbrough FW, Piepgras DG, et al. (1981) Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy with results of surgery and hemodynamics of cerebral ischemia. Mayo Clinic Proc 56:533–543Google Scholar
  30. 30.
    The Canadian Cooperative Study Group (1978) A randomized trial of aspirin and sulfinpyrazone in threatened stroke. New Engl J Med 299:53–59CrossRefGoogle Scholar
  31. 31.
    The EC/IC Bypass Study Group (1985) The international cooperative study of extracranial/ intracranial arterial anastomosis (EC/IC bypass study): Methodology and entry characteristics. Stroke 16:397–406CrossRefGoogle Scholar
  32. 32.
    The EC/IC Bypass Study Group (1985) Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. New Engl J Med 313:1191–1200CrossRefGoogle Scholar
  33. 33.
    Thompson JE, Austin DJ, Potman RD (1970) Carotid endarterectomy for cerebrovascular insufficiency: Long-term results in 592 patients followed 13 years. Ann Surg 172:663–679PubMedCrossRefGoogle Scholar
  34. 34.
    Tuomilehto J, Nissinen A, Wolfe E, et al. (1985) Effectiveness of treatment with antihypertensive drugs and trends in mortality from stroke in the community. Br Med J 291:857–861CrossRefGoogle Scholar
  35. 35.
    Warlow C (1984) Carotid endarterectomy: Does it work? Stroke 15:1068–1076PubMedCrossRefGoogle Scholar
  36. 36.
    Warlow C (1986) Personal communicationGoogle Scholar
  37. 37.
    Whisnant JP, Matsumoto N, Elveback LR (1973) Cerebral ischemia attacks in a community. Mayo Clinic Proc 48:194–198Google Scholar
  38. 38.
    Whisnant JP, Sandok BA, Sundt TM Jr. (1983) Carotid endarterectomy for unilateral carotid system transient cerebral ischemia. Mayo Clinic Proc 58:171–175Google Scholar
  39. 39.
    Wolf PA (1986) Cigarettes, alcohol and stroke. New Engl J Med 315:1087–1089PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1988

Authors and Affiliations

  • Sydney J. Peerless
    • 1
  • Henry J. M. Barnett
    • 1
  1. 1.Divisions of Neurosurgery and NeurologyThe University of Western OntarioLondonCanada

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