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Carotid Endarterectomy

Last Updated: August 24, 2018

Carotid Endarterectomy: Principles of Exposure, Arteriotomy and Patch Grafting

Carotid endarterectomy (CEA) is one of the most scrutinized surgical procedures in neurosurgery. Large trials have demonstrated definitive benefit in select patients with both symptomatic and asymptomatic carotid stenosis.  

Although many trials have been conducted about the effect of carotid endarterectomy in asymptomatic patients, three trials (The Veterans Administration Cooperative Study [VA], The Asymptomatic Carotid Surgery Trial [ACST], and the Asymptomatic Carotid Atherosclerosis Study [ACAS]) represent the bulk of the data in favor of CEA in this setting. 

  1. VA randomized 444 asymptomatic male veterans with carotid stenosis between 50% and 99%. All patients underwent conventional angiography for di...