Table 1:

Criteria for high-risk patients

Clinically significant cardiac disease

Congestive heart failure (New York Heart Association functional class III/IV)

Abnormal stress test

Need for open-heart surgery

Unstable angina (Canadian Cardiovascular Society class III/IV)

Left ventricular ejection fraction ≤30%

Planned coronary artery bypass graft or valve replacement

Severe pulmonary disease

Chronic obstructive pulmonary disease manifested with FEV ≤30%

Contralateral carotid occlusion or stenosis

Previous radical neck surgery or radiation therapy to the neck

Recurrent stenosis after endarterectomy

Age ≥75 years

Surgically inaccessible lesion at or above C2, or below clavicle

Laryngeal palsy or laryngectomy

Symptom onset within 2 weeks

Neurologic symptoms (National Institutes of Health Stroke Scale grade ≥4) within 48 hours from onset

Arteriosclerosis obliterans

Cancer

History of major surgery within the past year

Renal problems (creatinine level >1.5 mg/dL)