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Endarterectomy for Asymptomatic Carotid Artery Stenosis Executive Comm ACAS, JAMA 273:1421-1428, 1459995., , 1995 See this aricle in Pubmed Article Abstract After a medial follow-up of 2.7 years,with 4657 patient-years of observation,the aggregate risk over 5 years for ipsilateral stroke and any perioperative stroke or death was estimated to be 5.1%for surgical patients and 11.0%for patients treated medically(aggregate risk reduction of 53%[95%confidence interval,22%to 72%]).Patients with asymptomatic carotid artery stenosis of 60%or greater reduction in diameter and whose general health makes them good candidates for elective surgery will have a reduced 5-year risk of ipsilateral stroke if carotid endarterectomy performed with less than 3%perioperative morbidity and mortality is added to aggressive management of modifiable risk factors.

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