Stroke prevention by carotid endarterectomy

Abstract

Cerebrovascular disease is the third leading cause of death in Hong Kong and stroke is a major cause of disability in the elderly. With increased life span, rehabilitation and care of patients with disabiling stroke has become a substantial economic burden to the society and family. Prevention of stroke by carotid endarterectomy is definitely more cost-effective than treatment of stroke. Prospective randomized trials in North America and Europe have proven the benefit of carotid endarterectomy in symptomatic patients with severe carotid stenosis. The diagnosis of carotid stenosis can be easily confirmed by a duplex scan performed in experienced hands. With increased awareness of this condition, early identification of at risk patients with referral to a tertiary centre for consideration of carotid endarterectomy is able to reduce the risk of future stroke or death.