Carotid Endarterectomy Revisited

The importance of understanding the pathophysiologic basis of transient cerebral ischemia or ischemic stroke became clear with Fisher's original description of stroke in patients with atherothrombotic “occlusion of the internal carotid artery” in 1951. 1 Support for this concept that different arterial disorders produce ischemic stroke with definite topologic features (specifically, size and location) grew with Fisher's further pathological descriptions of lacunar and embolic stroke. He was the first to recognize that proper therapy required a precise pathophysiologic diagnosis that included not only characterization and localization of the ischemic disease in the brain, but also knowledge of the arterial disease and . . .