{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:53:52Z","timestamp":1791816832672,"version":"4.3.4"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1996,12]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            Our aim was to determine the perioperative morbidity and mortality rates of patients in the surgical arm of the multi-institutional, prospective, randomized Asymptomatic Carotid Atherosclerosis Study (ACAS).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            Of 828 patients with carotid stenosis of 60% or more randomized to the surgical arm of ACAS, 721 underwent carotid endarterectomy (CEA). To qualify for participation, surgeons were required to have performed at least 12 CEAs per year with a combined neurological morbidity and mortality rate no greater than 3% for asymptomatic patients and 5% for symptomatic patients. Clinical centers had to demonstrate arteriographic morbidity less than 1% and mortality less than 0.1% per year. Primary events were stroke and death in the period between randomization and 30 days after surgery; secondary events were transient ischemic attack and myocardial infarction occurring in the same period.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            Of the 721 patients who underwent CEA, 1 died and 10 others had strokes within 30 days (1.5%). Of the 415 who underwent arteriography after randomization but before CEA, 5 (1.2%) suffered transient ischemic attack or stroke caused by arteriography. Thus, a nearly equal risk of stroke was associated with both CEA and carotid arteriography. In addition, 6 transient ischemic attacks and 3 myocardial infarctions could be directly linked to CEA, for a total CEA event rate of 2.6%.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            Patients with asymptomatic internal carotid artery stenosis exceeding 60% reduction in diameter who are acceptable candidates for elective operation may be considered for CEA if the combined arteriographic and surgical complication rates are 3% or less.\n          <\/jats:p>","DOI":"10.1161\/01.str.27.12.2216","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:10:52Z","timestamp":1308341452000},"page":"2216-2224","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":154,"title":["An Analysis of Perioperative Surgical Mortality and Morbidity in the Asymptomatic Carotid Atherosclerosis Study"],"prefix":"10.1161","volume":"27","author":[{"given":"Byron","family":"Young","sequence":"first","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley S.","family":"Moore","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T.","family":"Robertson","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Toole","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin B.","family":"Ernst","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley N.","family":"Cohen","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Broderick","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Dempsey","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Hosking","sequence":"additional","affiliation":[{"name":"the Albert B. Chandler Medical Center, Lexington, Ky (B.Y., R.J.D.); Department of Surgery, University of California at Los Angeles Medical Center (W.S.M.); Department of Neurosurgery, University of Tennessee, Memphis (J.T.R.); Wake Forest University\/Bowman-Gray School of Medicine Medical Center, Winston-Salem, NC (J.F.T.); Department of Vascular Surgery, Henry Ford Hospital, Detroit, Mich (C.B.E.); Neurology Service, West Los Angeles (Calif) VA Medical Center (S.N.C.); University of Cincinnati ..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520420037035"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.20.7.2665205"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.22.11.1750041"},{"key":"e_1_3_2_4_2","unstructured":"Rose GA Blackburn H. Cardiovascular Surgery Methods. 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