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Fred A. Baughman, Jr, MD
5565 Grossmont Center Dr Bldg 1, Suite 206 La Mesa, CA 92041

Arch Neurol. 1988;45(7):714-715.

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

To the Editor.

—After 30 plus years of carotid endarterectomy, there is still no proof that even "in the best of hands" any patient group is afforded protection against stroke. What is incontrovertible is that carotid enderterectomy, as if penicillinlike, has become among the most frequent of operations that, nationwide, instead of protecting, is resulting in a net increase in stroke and death.

There were 15000 carotid endarterectomies performed in 1975;85000 in 1982;103000 in 1984; and 107000 in 1985. Brott and Thalinger¹ found that approximately half of these are performed for asymptomatic carotid disease. Whisnant² estimates, from epidemiologic studies, that 76000 of the 103000 carotid endarterectomies performed in 1984 were likely unnecessary.

In 1984, Dyken and Pokras³ reported that 2.8% of endarterectomy patients nationwide die before discharge from the hospital. Dyken⁴ remarked that "roughly 11.2% of those who have the operation die vs 2% . . . [Full Text PDF of this Article]

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