[Postoperative results of treatment in comparison with results of the German prospective randomized CASANOVA Study].
Independent of the results pending from the postoperative randomized German multicenter trial (CASANOVA Study), in which the course of operative versus non-operative treatment of asymptomatic carotid artery stenoses is being compared, there is still a clear justification for operative desobliteration if the following criteria are fulfilled: 1. Severe carotid stenosis with hemodynamic significance is proved by an extremely reduced or abolished autoregulatory reserve in the transcranial Doppler CO2-test. 2. Lesions with high embolic risk are confirmed by arteriography or B-Scan sonography. In 744 patients who underwent surgery according to these prerequisites there was a mere annual stroke rate of 0.2% during a followup of up to 18 years. This means that in comparison with the results of non-surgical therapy (annual stroke rate 1-3%) the risk of stroke was reduced by tenfold.
Hamann
H G
HG
Gefässchirurgische Klinik am Kreiskrankenhaus, Leonberg.
Vollmar
J F
JF
D002545:Brain Ischemia / Q000401:mortality / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery*; D002544:Cerebral Infarction / Q000401:mortality; D004691:Endarterectomy / Q000379:methods; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D015996:Survival Rate