A Systematic Review of Randomized Controlled Trials of Carotid Endarterectomy for Symptomatic Carotid Stenosis

Abstract

Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke but carries a risk of operative complications. ### Objectives The objective of this review was to determine the balance of benefit versus risk of endarterectomy plus best medical management in patients with recently symptomatic (transient ischemic attack or nondisabling stroke) carotid stenosis compared with best medical management alone.1 ### Search Strategy We searched the Cochrane Stroke Group Trials Register (July 2010), MEDLINE (1966 to March 2010), EMBASE (1990 to March 2010), and 3 other databases and hand-searched relevant journals and reference lists. ### Selection Criteria Randomized controlled trials comparing “best medical treatment plus endarterectomy” with “best medical therapy” in patients with carotid stenosis and a recent transient ischemic attack or nondisabling ischemic stroke in the territory of that artery. ### Data Collection and Analysis Two reviewers independently selected the studies and extracted the data. ### Main Results There have been 5 randomized trials of endarterectomy for recently symptomatic carotid stenosis, …