A fairly common surgical procedure called an endarterectomy may be overused, with its benefits overstated. An endarterectomy is the surgical removal of the innermost layers of a narrowed artery.
Endarterectomy may not be appropriate for most patients with asymptomatic carotid-artery stenosis.
These patients have a low risk of stroke.
Nearly half of the strokes that do occur in these patients with asymptomatic carotid-artery stenosis of 60% to 99% are caused by cardioembolism.
Focusing on controlling the four major risk factors for stroke - smoking, hypertension, elevated cholesterol, and blood glucose - will provide more benefits to most patients with asymptomatic carotid-stenosis than endarterectomy.
The greatest risk of large-artery stroke appears to be in patients with one or more of the following risk factors: a high degree of stenosis (narrowing), diabetes, or a silent brain infarction.
New England Journal of Medicine June 30, 2000;342:1693-1700,1743-1745.
Surgery is not the answer for most everyone with this problem, especially if it is not too far advanced. The first step of course is to get one's insulin levels balanced and the diet is a foundational step. EDTA chelation is also useful in many cases. The American College for Advancement in Medicine (ACAM) (714-583-7666) is the national group of physicians who perform this service.
If anyone does decide to go ahead with this or any other surgical procedure, be sure to follow a good nutritional protocol such as the one I have outlined to help promote healing.