Table 2.
Overview of carotid endarterectomy versus medical therapy trials.
| Trial (year) | Stenosis (%) | Treatment | Results |
|---|---|---|---|
| Symptomatic patients | |||
| NASCET (1991) | 70–99 | CEA + medical therapy versus medical therapy | 65% lower rate of ipsilateral cerebral events with CEA |
| ECST (1991) | 70–99 | CEA + medical therapy versus medical therapy | Incidence of ipsilateral ischemic stroke 2.8 versus 16.8% with aspirin alone |
| VA (1991) | 50–99 | CEA + medical therapy versus medical therapy | Death or stroke 7.7% with CEA versus 19.4% with medical therapy |
| Asymptomatic patients | |||
| ACAS (1995) | 60–99 | CEA + medical therapy versus medical therapy | Relative risk reduction of 53% with CEA |
| ACST (2004) | 60–99 | CEA + medical therapy versus medical therapy | 5-year stroke risk 6.4% with CEA versus 11.8% with medical management |
| VA (1993) | 50–99 | CEA + medical therapy versus medical therapy | 61% lower risk of TIA or stroke with CEA |
ACAS: Asymptomatic Carotid Atherosclerotic Study; ACST: Asymptomatic Carotid Surgery Trial; CEA: Carotid endarterectomy; ECST: European Carotid Surgery Trial; NASCET: North American Symptomatic Carotid Endarterectomy Trial; TIA: Transient ischemic attack; VA: The Veterans Affairs Cooperative Study Group.