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©2013 UpToDate ® Print Email Fatal or disabling stroke or perioperative death in the Asymptomatic Carotid Surgery Trial The risk of fatal or disabling stroke or perioperative death in the Asymptomatic Carotid Surgery Trial (ACST). The net five-year risk for fatal or disabling strokes or perioperative death in the CEA group was reduced by nearly half compared with the CEA deferral group. About one-half of the strokes in the trial were fatal or disabling. %: percent. Reproduced with permission from: MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 2004; 363:1491. Copyright © 2004 Elsevier.