Natali J, Kieffer E, Maraval M
J Mal Vasc. 1985;10 Suppl A:101-12.
In a series of 472 operations performed in 420 patients between 1981 and 1982, the mortality rate was 1.1% in asymptomatic patients (stage 0) and 2.1% in patients with transient ischaemic attacks (stage I) or with minor neurological sequelae (stage III). The morbidity rate of serious sequelae was 1.05%. The long term mortality is 30% at 5 years and 50% at 10 years, in most of the major statistical studies. The major cause of death (more than 50%) is myocardial infarction. The study of the local evolution of the operated artery reveals that about 10% of the patients who survived between 5 to 10 years had a recurrent carotid artery stenosis. Comparative studies of the course of the atherosclerotic disease operated patients and in patients treated medically are difficult to evaluate. However, most authors agree with Fields that an operation is justified in asymptomatic patients and in those presenting transient ischaemic attacks, provided the mortality and morbidity rate is less than 3%. Finally, recent studies stress the value of non-invasive investigations for determining the prognosis of tight stenoses: in asymptomatic patients with tight stenoses, the risk of a cerebrovascular accident is 5 times greater than in patients with a minor stenosis.
在1981年至1982年间对420例患者进行的472次手术中，无症状患者（0期）的死亡率为1.1%，短暂性脑缺血发作患者（I期）或有轻度神经后遗症患者（III期）的死亡率为2.1%。严重后遗症的发病率为1.05%。在大多数主要统计研究中，长期死亡率在5年时为30%，在10年时为50%。主要死因（超过50%）是心肌梗死。对手术动脉局部演变的研究表明，在存活5至10年的患者中，约10%有复发性颈动脉狭窄。对接受手术治疗的动脉粥样硬化疾病患者和接受药物治疗的患者的病程进行比较研究很难评估。然而，大多数作者同意菲尔兹的观点，即对于无症状患者和出现短暂性脑缺血发作的患者，只要死亡率和发病率低于3%，手术就是合理的。最后，最近的研究强调了非侵入性检查对于确定严重狭窄预后的价值：在无症状的严重狭窄患者中，脑血管意外的风险比轻度狭窄患者高5倍。
