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Seemant Chaturvedi, MD
From the Department of Neurology, Wayne State University–Detroit Medical Center, Detroit, Mich.

Arch Neurol. 1999;56:879-881.

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

AT PRESENT, rates of carotid endarterectomy (CE) are skyrocketing in the United States. A recent study found a 68% increase in the volume of CEs performed in Florida in the years 1995 and 1996, compared with the previous 3 years.¹ In the most rapidly growing segment of the population, the elderly, the rate of increase (92%) was even more staggering. This increase in surgical volume was accompanied by a $56 million increase in health care expenditures, which occurred in 1 state in only 1 year. A similar increase in the volume of CEs (43.4%) was also noted in Veterans Affairs hospitals in the United States for fiscal year 1995.²

Much of the current unbridled enthusiasm for CE is a result of the Asymptomatic Carotid Atherosclerosis Study (ACAS).³ The initial results of the ACAS were accompanied by a clinical alert from the National Institutes of Health, Bethesda, Md, . . . [Full Text of this Article]

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