To the Editor: Carotid artery disease is a common and treatable cause of transient ischemic attacks and strokes. Carotid endarterectomy is a safe and effective means of reducing neurological complications, including the risk of stroke,1 in the types of cases of severe internal carotid artery stenosis discussed in the Clinical Crossroads article by Dr Caplan.2 The question of optimal timing of surgery following the incident event is critical to discuss in this patient population, especially since “early” intervention has had different meanings in various trials and timing may be associated with important effects on outcome.
Kapoor JR. Carotid Endarterectomy and Statin Therapy in the Management of Patients With Carotid Artery Disease. JAMA. 2008;300(18):2117-2119. doi:10.1001/jama.2008.582