[Epidemiology, natural history and indications for carotid thromboendarterectomy].

Stroke is the third most common cause of death in the occidental population and most important cause of disability. The average annual incidence of cerebral ischemia is increasing linked to population's mean age that is growing together with risk factors for cerebrovascular disease. There are many multicentre randomised trials (NASCET, ECST, Vet. Adm. SCT, CASANOVA, ACSV Adm. Study, ACAS, ACST) that identify surgical therapy as a prevention for stroke in symptomatic and asymptomatic patients. In discussing about all these studies it appears the necessity to follow the surgical guide-line proposed by multicentre trials in order to uniform indications for surgical or conservative therapy and to obtain data and results good enough to be effective in preventing really efficaciously stroke.