TECHNICAL ISSUES IN CAROTID-ARTERY SURGERY 1995

IN REVIEWS IN the 1980s, we discussed both indications for and surgica l techniques in carotid endarterectomy. Significant changes in the pra ctice of extracranial cerebrovascular reconstruction have occurred ove r the past few years. The newest indications and cooperative study dat a have recently been discussed by Camarata and Heros in this topic rev iew series. In this article, we aim to review the advances in operativ e monitoring and surgical techniques of the last decade. We would be r emiss, however, not to note that the latest Asymptomatic Carotid Ather osclerosis Study data, released in September 1994, indicate that carot id endarterectomy is significantly superior to medical therapy for asy mptomatic stenosis of >60%. These data, along with the North American Symptomatic Carotid Endarterectomy Trial results, will revitalize and lend scientific validity to carotid artery reconstruction.