Council of State Neurosurgical Societies Resident Award: The Utilization of Carotid Endarterectomy by Neurosurgeons in the United States from 1990 to 2000

摘要

In 1951, an Argentinean neurosurgeon, Raul Carrea, per-foimed the first documented internal carotid artery surgery for the prevention of cerebral ischemia. The patient was a 41-year-old businessman with recurrent hemiplegia and transient monocular blindness. After reviewing C. Miller Fisher's work linking carotid artery disease to cerebral ischemia, Carrea was inspired to excise the atherosclerotic segment of internal carotid artery. He then performed an end-to-end external carotid to internal carotid artery anastomosis. At 39-months follow-up the patient had a normal motor examination and left eye blindness. Carrea's initial success was followed by Eastcott et al, and DeBakey's reports of surgical correction of symptomatic extracranial carotid artery disease.The use of carotid endarterectomy (CEA), thereafter, was sporadic with no clear indications and little scientific evidence supporting its efficacy.