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Article
July 1988

Can Carotid Endarterectomy Be Justified?

Author Affiliations

Department of Neurology The University of Texas Medical School Houston, TX 77030

Arch Neurol. 1988;45(7):715. doi:10.1001/archneur.1988.00520310017007
Abstract

To the Editor.  —I read with great interest the opposing opinions of Patterson and Jonas concerning justification of carotid endarterectomy that appeared in the June 1987 issue of the Archives.1,2 It was amusing that both authors presented statistics from the Joint Study of Extracranial Arterial Occlusion3 to support their convictions.The table in the article by Jonas includes 78 patients of 183 described in a report by Bauer et al.4 Dr Bauer was a principal investigator in the Joint Study, and these same patients that he described were also described in the final Joint Study results published in 1970. Therefore, there was some duplication in Jonas' table.Dr Patterson believes, "Using not only stroke but also death as end points after surgery seems unfair." However, it is important that deaths be counted as end points. Otherwise, study results would not reveal deaths caused by some side effect of the therapy

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