ABSTRACT
The risk model will also be useful in targeting angiopiasty and stenting, in which the main determinant of likely benefit in individuals is also the risk of stroke on medical treatment alone.
6. SUMMARY
We now have highly consistent, and reliable data on the degree of stenosis above which endarterectomy for symptomatic carotid stenosis is beneficial. There is a major benefit in patients with 70-99% stenosis, modest benefit in patients with 50-69% stenosis and, no evidence of benefit in patients with <50% stenosis or near-occlusion. However, benefit is also influenced by other factors, particularly age, sex, the timing of surgery, plaque surface
Figure 7 A plot of the total risk score derived from the table against the 5-year predicted risk of ipsilateral carotid territory ischemic stroke derived from the full model in the table in patients in the ECST (thick line). This should be used as a nomogram for the conversion of the score into a prediction of the percentage risk. The thin line represents a 20% reduction in risk as might be seen with more intensive medical treatment than was available in the ECST in the late 1980s and 1990s.
