o:2910 Carotid endarterectomy has significantly lower risk in the last two decades en ABSTRACT: Carotid endarterectomy (CEA) carries a significant risk of procedural stroke and death Guidelines recommend keeping this risk below 6% and below 3% for symptomatic and asymptomatic patients respectively. After analyzing our Institute’s CEA results during the past 25 years, we found the rate of postoperative complications was now well below Guideline thresholds. Accordingly, we studied temporal changes in procedural risks in randomized controlled trials (RCTs) and in large observational studies in order to compare these against Guidelines. We found a clear temporal trend towards improving procedural outcomes, which can be explained by improvements in medical therapy, more appropriate timing of CEA, the use of local anesthesia and the use of peroperative cerebral monitoring as well as improving surgical techniques. An update of current guidelines should now be undertaken, since our findings are not unique and are supported by other studies in this review. Accepted version Key words: endarterectomycarotid, guideline, carotid stenosis 91552100 126307593 1552101 1827-191X 1552099 10.23736/S0021-9509.17.09742-7 2023-10-04T10:30:50.990Z 44 yes 46 Đorđe Radak 12465767 0000-0003-3199-5613 2018 46 Djurre de Waard 0000-0001-6385-2065 46 Alison Halliday 0000-0001-9828-3579 46 Mihailo Nešković 29988455 0000-0003-4829-985X 2018 46 Slobodan Tanasković 19201127 0000-0003-4216-6693 2018 application/pdf 789708 https://unilib.phaidrabg.rs/o:2910 no yes 1 Podaci o dostupnosti prema https://v2.sherpa.ac.uk/id/publication/32235?template=romeo 70 92000002 71A11 Journal of Cardiovascular Surgery 59 4 586 645 2018