title: Durability of carotid endarterectomy.
abstract: OBJECTIVE
  We sought to determine the incidence of recurrent stenosis after carotid endarterectomy.
  
  
  METHODS
  One thousand consecutive carotid endarterectomy patients were followed prospectively. The surgery was performed in a standard fashion. Cerebral protection was provided with intraoperative electroencephalographic monitoring and selective shunting. All arteriotomies were repaired with a patch graft. Each patient was seen 3 months after surgery and then yearly, with a duplex ultrasound obtained at each visit. Evidence for new ischemic events or recurrent stenosis of >or=70% was recorded.
  
  
  RESULTS
  The 30-day combined minor and major stroke and death rate was 1.9%. At 7.1-year follow-up, 0.1% of patients had recurrent stenosis >or=70%, the majority of which were asymptomatic.
  
  
  CONCLUSIONS
  Carotid endarterectomy is a low-risk procedure for the treatment of carotid occlusive disease, with excellent long-term durability. Although less invasive, carotid angioplasty must demonstrate equal robustness in long-term follow-up before it is considered a routine alternative to surgery.
authors: Department of Neurosurgery, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
authors: Robert D
authors: RD
authors: Ecker
authors: Mark A
authors: MA
authors: Pichelmann
authors: Irene
authors: I
authors: Meissner
authors: Fredric B
authors: FB
authors: Meyer
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000706:statistics & numerical data; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008910:Minnesota; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D014463:Ultrasonography