THE CHANGING INDICATIONS FOR CAROTID ENDARTERECTOMY IN THE UK

In early series the majority of carotid endarterectomies were performe d in patients with amaurosis fugax (AFx) or transient ischaemic attack s (TIAs) who were thought to have atheromatous ulcers of the carotid b ifurcation or the internal carotid artery (ICA), The degree of stenosi s was considered to be of secondary importance. We compared our own da ta with two British series undertaken in the early and late 80s/early 90s, This reflects the broadening of indications and the change of pra ctice for carotid endarterectomy over the years, on the one hand towar ds including patients who are at greater risk of perioperative stroke (previous CVAs vs TIAs, crescendo TIAs and stroke in evolution), and o n the other towards patients who have had no symptoms attributable to the carotid lesion (asymptomatic cases, combined carotid and cardiac p rocedures).