Endarterectomy for Stenosis of 70% or Greater With Symptoms

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Research clearly shows that carotid endarterectomy has more benefits than treatment with medicine if you have symptoms and 70% or greater stenosis (narrowing). Symptoms include a previous TIA or mild stroke. footnote 1

Most people in this group can significantly reduce their risk of stroke by having an endarterectomy if they are healthy enough to have surgery and they have a highly skilled surgeon who has a low complication rate. A low complication rate means the surgeon has had only a small number of patients who, because of the surgery, have a stroke or other complications.

Research suggests that the surgeon should have a complication rate of no more than 6% for this procedure to be considered beneficial for his or her patients. If the rate is higher than 6%, the risks outweigh the benefits. This means that you are more likely to have complications from the surgery than to benefit from long-term reduction in your risk of stroke. footnote 2

To find your surgeon's complication rate, check with his or her office, the hospital where the surgery will be done, and your state's medical association. Access to this information may vary by state.

Another thing to think about is the hospital itself. In general, larger hospitals and regional medical centers have staffs that do more carotid endarterectomies than those in smaller hospitals. Check to see how many of these procedures are done in your hospital each year.


  1. Rerkasem K, Rothwell PM (2011). Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database of Systematic Reviews (4).
  2. Kernan WN, et al. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7): 2160-2236. DOI: 10.1161/STR.0000000000000024. Accessed July 22, 2014.

ByHealthwise Staff

Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine

Martin J. Gabica, MD - Family Medicine

Adam Husney, MD - Family Medicine

Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology

Current as ofOctober 5, 2017