New guideline, published in the Neurology, has updated the 1990 AAN ( American Academy of Neurology ) statement on carotid endarterectomy.

Carotid endarterectomy is a surgical procedure that removes plaque and fatty deposits from blocking the carotid arteries which are the main suppliers of blood for the brain.
There is strong evidence recommending carotid endarterectomy to prevent stroke in people who have severe ( 70 to 99 percent ) blockage in their carotid artery.
Nearly 25 percent of people who recover from their first stroke will have another stroke within five years.

The guideline found that carotid endarterectomy is effective for patients with severe stenosis and recent symptoms of stroke or transient ischemic attack ( TIA or mini-stroke ).
Carotid endarterectomy may also be considered for patients with moderate ( 50 to 69 percent ) stenosis and recent symptoms of stroke.

For people between the ages of 40 – 75 years with moderate to severe narrowing, but presenting with no symptoms of stroke or disease, carotid endarterectomy may be considered if the patient has at least a five-year life expectancy and if the surgery can be done with a low complication rate.

" The evidence of this guideline points out an effective method of stroke prevention in certain people," said Seemant Chaturvedi, guideline author and director of the Wayne State University Stroke Program. " Carotid endarterectomy is beneficial for those with severe to moderate narrowing in their carotid artery."

For patients with less than 50 percent stenosis, medical treatment is preferred over carotid endarterectomy.

People who undergo carotid endarterectomy should receive low-dose Aspirin therapy ( 81 to 325 mg per day ) prior to surgery and for at least three months following surgery, according to the guideline.

There is not enough evidence for or against having a carotid endarterectomy within four to six weeks of a moderate to severe stroke.

Source: American Academy of Neurology, 2005


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