Surgical desobliteration of the internal carotid artery is a highly effective option
for primary or secondary prophylaxis of stroke in patients with significant symptomatic
or asymptomatic carotid artery stenosis (evidence-level 1a). To avoid early recurrence
of neurological symptoms in symptomatic patients operation should be performed within
two weeks after the initial neurological event. Despite early operation risk of carotid
surgery remains low in experienced centres. Adherence to the time frame can be improved
by structured interdisciplinary teamwork in a stroke center and may serve as a quality
marker. Center specific complications rates have to be taken into account and should
be below 3% in asymptomatic patients and 6% in symptomatic patients for combined stroke/death.
Benefit of the eversion technique is the reduced re-stenosis rate, whereas endarterectomy
offers the benefit of easy use of a shunt. Quality control of the surgical work forms
part of the surgical concept.
Keywords
Stroke - carotid artery stenosis - TEA/EEA
