Early carotid endarterectomy is associated with improved outcomes

Shown is the absolute reduction with surgery in the five-year cumulative risk of ipsilateral carotid ischemic stroke and any stroke or death within 30 days after carotid endarterectomy (CEA) in patients with 50 to 69 percent stenosis and ≥70 percent stenosis without near occlusion stratified by the time from last symptomatic event to randomization. Numbers above the bars indicate actual absolute risk reduction. Vertical bars are 95 percent confidence intervals. These results suggest that CEA is likely to be of greatest benefit if performed within two weeks of the last neurologic event in patients with ≥70 percent carotid stenosis. For patients with 50 to 69 percent stenosis, CEA may only have benefit if performed within two weeks of the last event.