Carotid endarterectomy without angiography: a prospective randomised pilotstudy

Objectives: to determine whether duplex ultrasonography alone is an adequat e examination prior to carotid endarterectomy. Design: prospective, randomised, single centre stimy. Material and Methods: all patients with carotid bifurcation stenosis greate r than 70% - based on duplex scanning were randomised to arteriography foll owed by carotid surgery (Group A; n = 96) or cartid surgery alone (Group B; n = 90). Study endpoints were neurological complications or death ocnlruin g between the day of randomisation and until 30 days after surgery. Results: major neurological complications of death in 1 (1%) vs 3 (3.3%) pa tients in group A and B, respectively (n.s.). Minor neurological complicati ons (only TIA) were observed in 0 and 3 (3.3%) patients, respectively. Conclusions: complication rates were low in both groups and within the gene rally accepted rate after carotid surgery in asymptomatic and symptomatic p atients.