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John E. Castaldo, MD
From Lehigh Neurology, Allentown, Pa.

Arch Neurol. 1999;56:877-879.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

WITH THE publication of the Asymptomatic Carotid Atherosclerosis Study (ACAS) results in 1995,¹ much controversy again arose over whether to offer carotid endarterectomy (CE) to asymptomatic patients with severe carotid stenosis.^2-4 In 1985, when laying the ground work for this trial, the investigators had hoped to end much of the controversy and settle what was then felt to be a simple but important question: Is CE helpful or harmful to asymptomatic patients harboring carotid lesions of hemodynamic significance? To my thinking, 3 basic conclusions came from that work: First, that skilled surgeons could perform CE with a 5-year morbidity and mortality rate that was less than half of that obtained with the best medical management alone. Second, the absolute risk of stroke and death with medical management was only 2.3% per year, which was less than half that predicted from historical data available at the time. . . . [Full Text of this Article]

CAROTID


ACCESS

RISKS

OUTLOOK

TRANSIENT ISCHEMIC ATTACKS

ILLNESS

DISCLOSURE/DISCUSSION

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