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NASCET
About the Trial
The North American Symptomatic Carotid Endarterectomy Trial randomized 2,885 patients with recent TIA or minor stroke and carotid stenosis to surgery plus medical care or medical care alone. For severe stenosis, 70 to 99 percent, surgery sharply reduced ipsilateral stroke, preventing about one ipsilateral stroke at two years for every six patients treated. For stenosis under 50 percent, surgery showed no significant benefit. The European ECST trial concurred after methodological alignment. NASCET defined exactly who benefits from carotid endarterectomy, making it among the most precisely indicated operations in medicine. It also established the randomized evaluation of a surgical procedure against medical therapy as both feasible and essential.
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