The North American Symptomatic Carotid Endarterectomy Trial (NASCET) was published in NEJM in 1993[^1] and demonstrated the high efficacy of a Carotid endarterectomy in patients with high-grade carotid stenosis of 70% to 99%%[^1].
Authors' Conclusion
Carotid endarterectomy reduced the overall incidence of ipsilateral neurologic events in a selected group of male patients with asymptomatic carotid stenosis. We did not find a significant influence of carotid endarterectomy on the combined incidence of stroke and death, but because of the size of our sample, a modest effect could not be excluded. [^1]