Carotid endarterectomy for stroke prevention.

Minor neurologic signs or transient ischemic attacks (TIAs) precede stroke in 50 percent of patients. In men, antiplatelet therapy decreases the risk of recurrent TIA and stroke. Carotid endarterectomy for TIA is now one of the most commonly performed vascular operations. Preoperatively, the arterial anatomy of the patient must be carefully studied by conventional angiography or digital subtraction angiography. The goal of surgery is to eliminate the atherosclerotic plaque and restore the artery to its normal size with a smooth intima.