A comparison of the Society for Vascular Surgery and the European Society for Vascular Surgery guidelines to identify which asymptomatic carotid patients should be offered a carotid endarterectomy

Abstract

The management of patients with asymptomatic carotid stenosis (ACS) remains enduringly controversial and is the subject of extensive debate. Three landmark randomized controlled trials (RCTs) showed that carotid endarterectomy (CEA) conferred an approximately 50% relative risk reduction in the 5-year stroke risk compared with best medical therapy (BMT) alone.1-3 Based on these results, national and international guidelines recommended CEA for patients with ACS to reduce the risk of a future cerebrovascular event.