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Steven T. DeKosky, MD

Arch Neurol. 2003;60:778-779.

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

IN THIS month's "Controversies in Neurology" section, Dr Chaturvedi proposes that the NASCET¹ and ACAS² should be repeated. Actually, Dr Chaturvedi's well-reasoned argument is not so much for a replication of those studies but a rationale for the next NASCET and ACAS studies. He believes that they are outdated, a circumstance that is frequently the fate of such large, long, and difficult-to-perform multicenter trials. However, Dr Chaturvedi's call is really for 2 studies, 1 specifically targeted at the group with intermediate carotid stenosis (50%-75%), whose outcome was not markedly different with surgery vs best medical therapy. His argument is that with new medications, best medical therapy would show significant improvement compared with surgery. These 2 new studies would examine best medical therapy alone vs best medical therapy plus carotid endarterectomy in asymptomatic and symptomatic patients who have carotid stenosis of 50% to 75%.

Dr Moore takes . . . [Full Text of this Article]

From the Department of Neurology, University of Pittsburgh, Pittsburgh, Pa.

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