Carotid endarterectomy without angiography: a prospective randomised pilot study

Objectives: to determine whether duplex ultrasonography alone is an adequate examination prior to carotid endarterectomy. Design: prospective, randomised, single centre stimy. Material and Methods: all patients with carotid bifurcation stenosis greater than 70% - based on duplex scanning were randomised to arteriography followed by carotid surgery (Group A; n = 96) or cartid surgery alone (Group B; n = 90). Study endpoints were neurological complications or death ocnlruing between the day of randomisation and until 30 days after surgery. Results: major neurological complications of death in 1 (1%) vs 3 (3.3%) patients in group A and B, respectively (n.s.). Minor neurological complications (only TIA) were observed in 0 and 3 (3.3%) patients, respectively. Conclusions: complication rates were low in both groups and within the generally accepted rate after carotid surgery in asymptomatic and symptomatic patients.