Misconceptions regarding the adequacy of best medical intervention alone for asymptomatic carotid stenosis.

Background: Medical intervention (risk factor identification, lifestyle coaching, and medication) for stroke prevention has improved significantly. It is likely that no more than 5.5% of persons with advanced asymptomatic carotid stenosis (ACS) will now benefit from a carotid procedure during their lifetime.

Risk of early recurrent stroke in symptomatic carotid stenosis after best medical therapy and before endarterectomy.

Background: The early recurrence of neurological symptoms (NR) after urgent aggressive best medical therapy (BMT) in symptomatic carotid stenosis is not well documented.

Aims: To investigate the risk of ipsilateral NR after urgent aggressive BMT in patients with symptomatic (50-99%) carotid stenosis up to carotid endarterectomy (CEA), with emphasis on the first 14 days after index-event.

Methods: Prospective population based study, covering a period of 4½ years.

Clinical validation of 40-mmHg carotid stump pressure for patients undergoing carotid endarterectomy under general anesthesia.

Background: The aim of this study was to validate a mean stump pressure (SP) of 40 mmHg as the cut off threshold for shunting during carotid endarterectomy (CEA).

Methods: A prospective analysis of recently symptomatic carotid stenosis patients undergoing fast-track CEA under general anesthesia. An arbitrary cut-off threshold of 40 mmHg (mean) was defined as the indication for shunt insertion.

Urgent best medical therapy may obviate the need for urgent surgery in patients with symptomatic carotid stenosis.

Background And Purpose: The purpose of this study was to analyze the 30-day outcome after introduction of a rapid carotid endarterectomy (CEA) program. Reasons for delay in CEA and the incidence of early recurrence neurological symptoms were recorded.

Methods: This is a prospective population-based study of delays to CEA and 30-day outcome in patients with symptomatic carotid stenosis.