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I certainly have no disagreement with Drs Oller and Deaner regarding early operation following an acute occlusion. This is rarely done except under the most unusual of circumstances. For example, if a patient in the hospital has a carotid bruit on admission and suddenly a contralateral hemiplegia develops with disappearance of the bruit, I would have such a patient taken directly to the operating room without an arteriogram on the assumption that a stenotic artery had abruptly become occluded by thrombus. I have had this experience only on two occasions out of many, and the result in each instance was prompt and virtually complete recovery.
I am familiar with the recent paper from Dr Oller and his colleagues regarding a noninvasive modality for the accurate diagnosis of carotid occlusion. There are many other satisfactory techniques for accomplishing this purpose. I still feel very strongly that there is little
Fields WS. Carotid Artery Occlusion-Reply. JAMA. 1976;236(21):2391–2392. doi:10.1001/jama.1976.03270220013008
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