The results of surgical treatment of TIA's: lessons for future case selection.

Carotid endarterectomy is a valuable preventive measure in some carefully selected patients with warning attacks. The cooperation of a specified neurologist is essential. Higher than average coronary and other morbidity risks require thorough general review, preferably by a cardiologist member of the vascular team. Well timed coronary bypass surgery can reduce the unacceptable high operative and late mortality in patients with manifest ischaemic heart disease. Perioperative stroke may be more related to overall vascular surgical experience than to the particular method of cerebral protection adopted. Combined stroke/mortality figures of less than 5% should be the objective.