In Reply: Dr Zazulia points out that large randomized controlled trials have failed to demonstrate a benefit for revascularization therapy in women with asymptomatic carotid disease. In this context, asymptomatic indicates an absence of ipsilateral TIA or stroke symptoms rather than an absence of cognitive decline, which indeed has been linked with carotid disease.1
Ellison JM. Mild Cognitive Impairment, Carotid Disease, and Revascularization—Reply. JAMA. 2009;301(8):829–830. doi:10.1001/jama.2009.173
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