ASYMPTOMATIC CAROTID STENOSIS

Several studies were undertaken to evaluate the possible benefit of ca rotid endarterectomy in asymptomatic carotid stenosis. The interim res ults of the ACAS study have shown a reduction of ipsilateral infarctio ns and perioperative infarction or death from 11% in the medically tre ated group to 5.1% in the surgically treated group with a risk reducti on of 53%. Since 19 thrombendarterectomies were needed to prevent one stroke in 5 years, operation is not generally recommended in asymptoma tic carotid stenosis. Further investigation needs to be done to define additional criteria for the identification of those patients having h ighest benefit from surgical therapy. In absence of contraindications patients with asymptomatic carotid stenosis should be treated with 100 -300 mg acetylsalicylic acid daily.