Public health impact of carotid endarterectomy

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Despite the completion of several multi-center clinical trials comparing medical management and carotid endarterectomy, there is still controversy as to when carotid endarterectomy is appropriate. The volume of this surgery appears to be increasing. However, available performance data indicate that the surgical proficiency required for the clinical trials is not achieved uniformly in actual practice. Therefore, benefits of carotid endarterectomy, when considered from a public health perspective, are limited by the following: (1) endarterectomy is an expensive stroke prevention modality; (2) endarterectomy addresses the needs of only a relatively small subset of stroke patients, and (3) endarterectomy for asymptomatic patients, without clearer evidence that these individuals benefit, may decrease the cost- effectiveness of this surgical procedure.

Original languageEnglish (US)
Pages (from-to)15-21
Number of pages7
JournalNeuroepidemiology
Volume18
Issue number1
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

Keywords

  • Carotid endarterectomy
  • Carotid stenosis
  • Transient ischemic attack

ASJC Scopus subject areas

  • Epidemiology
  • Clinical Neurology

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