抄録
In the randomized control studies (RCS) as NASCET, ECST, ACAS et al., the benefit of carotid endarterectomy (CEA) for the cases with high-grade carotid artery stenosis have been presented. However, some controversies still remain and evaluation of endovascular stenting vs CEA is noticed as a recent subject in this field. In this report, we presented dthe following subjects ; 1) clinico-pathological features of an atheromatous plaque of carotid artery suggesting the significance of surgical removal of the symptomatic lesions, 2) reviw of the literature and clinical analysis of the reported RCSs, 3) results of retrospective investigations of CEA and stenting in the neurosurgical institutes during 2000 and 2001.
In the retrospective study, 2, 818 CEAs and 1, 084 endovascular treatment was performed in 637 institutes during this two years. Number of cases in about 80% of institutes were less than 10, and moderate indications have been considered, especially in an asymptomatic case, in the most institutes. In Japanese, occlusive carotid artery disease is not so common and some characteristic clinical features have been noticed compared with Caucasians. Prospective and original studies designed for Japanese will be needed to discuss and select an adequate treatment indications.
