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Patients with carotid artery stenosis had a high risk for stroke, and some types of stroke were not prevented by endarterectomy

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 QUESTION: In patients with internal carotid artery (ICA) stenosis, what are the causes and severity of stroke for varying degrees of stenosis?


Cohort study using data from the North American Symptomatic Carotid Endarterectomy Trial (NASCET) with mean follow up of 5 years.


106 centres mostly in North America.


2885 patients (median age 67 y, 70% men) with ICA stenosis.

Assessment of risk factors

ICA stenosis measured by angiography and duplex ultrasonography; categories of stenosis were <60%, 60% to 69%, and 70% to 99%.

Main outcome measures

Ischaemic strokes were classified as large artery, lacunar, or cardioembolic (possible or probable) strokes. Severity was also assessed (non-disabling, disabling, or fatal).

Main results

During follow up, 749 patients had 1039 …

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  • Source of funding: National Institute of Neurological Disorders and Stroke.

  • For correspondence: Dr H J Barnett, John P Robarts Research Institute, PO Box 5015, 100 Perth Drive, London, Ontario N6A 5K8, Canada. Fax +1 519 663 3789.