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December 1, 1999

National Stroke Association Guidelines to Prevent Stroke—Reply

Author Affiliations

Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor

JAMA. 1999;282(21):1999-2001. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-21-jbk1201

In Reply: Dr Chaturvedi's points about CE for asymptomatic stenosis are well taken, but his representation of the NSA consensus statement is misleading. The consensus statement is careful to point out that not all guidelines have embraced the ACAS result. We discuss several reservations about the ACAS results; among them is the strongest, expressed by Chaturvedi, that the excellent surgical morbidity and mortality results in ACAS may not be matched in the community. Our statement emphasizes, "Without assurance that the local surgical risk is acceptable . . . CE cannot be recommended."