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September 3, 1982

Carotid Stenosis and Ulcerative Plaque

JAMA. 1982;248(9):1066. doi:10.1001/jama.1982.03330090038021

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To the Editor.—  I have read the account in MEDICAL NEWS by Mr William A. Check, on "Carotid Endarterectomy's Value Still Uncertain" (1982; 247:1802). This was a report of a study that was done with my colleagues, Drs B. A. Sandok and T. M. Sundt, Jr. Although there are always minor points that might be raised after a reporter presents his understanding of a scientific presentation, on this occasion Mr Check has included one statement that may be highly misleading to readers. In referring to our patients who had carotid endarterectomy, he noted that, "None of the stenoses were complicated by ulcerative plaque." That statement was not made in the presentation or in his interview later.This is a critical point, as a high percentage of severe stenoses of the common and internal carotid arteries are associated with ulceration of the plaque, whether or not it is evident on angiographic