Carotid endarterectomy: a report of 7854 procedures using local anesthesia, electroencephalographic monitoring, occlusion catheters, and the pruitt-inahara carotid shunt.

Accumulation of data through prospective studies has seemed painstakingly slow, but during the past 25 years several major prospective studies have published results conclusively demonstrating that carotid endarterectomy is superior to medical management in certain categories of patients with carotid stenosis. These prospective studies are as follows: (1) the Joint Study of Extracranial Arterial Occlusion; (2) the North American Symptomatic Carotid Endarterectomy Trial (NASCET); (3) the European Carotid Surgery Trial (ECST); (4) the V.A. Symptomatic Carotid Endarterectomy Trial; and (5) the Asymptomatic Carotid Atherosclerosis Study (ACAS).