Endarterectomy for Stenosis of Less Than 50% Without Symptoms

Research shows that there is no benefit to having endarterectomy if you have less than 50% stenosis (narrowing) and no symptoms, such as a previous TIA or mild stroke.footnote 1 People in this group do not benefit from endarterectomy. They actually increase their risk of stroke or death from surgery because of complications of the procedure. For people with less than 50% stenosis who do not have symptoms, the American Heart Association and American Stroke Association recommend treatment with medicine and lifestyle changes.footnote 2

This group is already at a lower risk for stroke than those with a higher degree of stenosis. So having surgery would not likely further reduce that risk. It would instead introduce new risks linked with surgery.


  1. North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. New England Journal of Medicine, 325(7): 445–453.
  2. Meschia JF, et al. (2014). Guidelines for the primary prevention of stroke: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, published online October 28, 2014. DOI: 10.1161/STR.0000000000000046. Accessed October 29, 2014.

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Karin M. Lindholm, DO - Neurology

Current as ofFebruary 20, 2015

Current as of: February 20, 2015