Surgical Treatment of Extracranial Carotid Occlusive Disease

This report has reviewed the preoperative evaluation, operative technique, postoperative care, results, and representative pathological findings in 225 carotid endarterectomies. Surgery is generally indicated in patients with: 1. TIA's, and carotid stenosis (lumen diameter less than 2 mm.) or an ulcerated plaque. 2. A stable, mild to moderate neurological deficit with or without TIA's, and carotid stenosis (lumen diameter less than 2 mm.) or an ulcerated plaque. 3. An acute progressive or fluctuating neurological deficit, and carotid stenosis (lumen diameter less than 2 mm.) or carotid occlusion. Surgery should be considered in some patients with: 1. TIA's, and ipsilateral carotid occlusion. 2. An acute partial persistent neurological deficit, and carotid stenosis (lumen diameter less than 2 mm.) or occlusion. 3. No symptoms, and carotid stenosis (lumen diameter less than 2 mm.). Surgery is generally not indicated in patients with an acute severe persistent neurological deficit, and carotid stenosis or occlusion.