title: [Indications for endarterectomy in asymptomatic stenoses of the internal or common carotid artery--results of the North American ACAS Study].
abstract: OBJECTIVE
  To determine the effect of endarterectomy on the primary prevention of ischemic stroke in patients with asymptomatic carotid artery stenosis.
  
  
  METHODS
  In a prospective, randomized, multicenter trial 1659 patients with asymptomatic carotid stenosis of 60% or more were studied in two treatment arms (endarterectomy: n = 825; medical therapy: n = 834). Endpoints were: (1) ischemic stroke in the vascular territory of the study artery, (2) any perioperative stroke or any perioperative death.
  
  
  RESULTS
  The Kaplan-Meier 5-year-risk estimation showed a relative risk reduction of 53% (confidence interval: 22%-72%) for patients in the surgical arm. The combined perioperative morbidity and mortality rate was 2.3%.
  
  
  CONCLUSIONS
  Endarterectomy of asymptomatic carotid artery stenosis performed with a perioperative complication rate of less than 3% reduces the 5-year risk of ipsilateral stroke.
authors.affiliation: Neurologische Abteilung, Neurovaskuläre Einheit, Universitätsklinikum Benjamin Franklin, Freien Universität, Berlin.
authors.forename: H
authors.initials: H
authors.lastname: Mast
authors.forename: L E
authors.initials: LE
authors.lastname: Chambless
authors.forename: J P
authors.initials: JP
authors.lastname: Mohr
authors.forename: J F
authors.initials: JF
authors.lastname: Toole
mesh_terms: D000328:Adult; D000368:Aged; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000401:mortality / Q000517:prevention & control*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*; D011446:Prospective Studies; D012306:Risk; D015996:Survival Rate; D016896:Treatment Outcome
vernacular_title: Zur Indikation der Endarterektomie bei asymptomatischen Stenosen der Arteria carotis interna oder communis--die Ergebnisse der nordamerikanischen ACAS-Studie.