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June 7, 1995


Author Affiliations

University of Rochester, Rochester, NY

JAMA. 1995;273(21):1695-1697. doi:10.1001/jama.1995.03520450065033

Major advances in the molecular and genetic bases of neurological disease have continued to be the the major focus in the field of neurology. However, notable progress has been made in the prevention, diagnosis, and treatment of neurological disorders. Numerous clinical trials of various drugs and procedures are under way in patients with disorders long resistant to any therapeutic approaches.

The vexing question of whether to operate in cases of asymptomatic internal carotid artery stenosis has been the subject of a large, randomized controlled clinical trial. The interim results of this trial were released in a National Institute of Neurologic Diseases and Stroke Clinical Advisory.1 The conclusion was that carotid endarterectomy is beneficial for patients with asymptomatic carotid stenosis exceeding 60% of diameter reduction as confirmed by arteriography. Results were dependent on medical centers and surgeons who had a perioperative morbidity and mortality rate lower than 3%. Men had

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