Citations 0
Controversies in Neurology
May 2003

How Should We Design Studies for Stroke Prevention?

Author Affiliations

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




Copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2003

Arch Neurol. 2003;60(5):778-779. doi:10.1001/archneur.60.5.778

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 He believes that they are outdated, a circumstance that is frequently the fate of such large, long, and difficult-to-perform multicenter trials.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%.

First Page Preview View Large
First page PDF preview
First page PDF preview