Overwhelming proof exists that ischemie stroke can be prevented, or at least delayed, for a large number of individuals. Many strokes that resulted from severe symptomatic carotid artery stenosis need happen no longer. Effective treatments have been established by the time-consuming and expensive process of randomized clinical trials. Alas, all other methods seeking the truth about therapeutic benefit are less perfect and frequently misleading. Paradoxically, endarterectomy is complicated by stroke, the very disaster that it effectively reduces. This paradox demands of the practitioner that the indications for this therapy and the care with which it is administered must be precisely defined and scrupulously monitored. This communication will discuss who should and who should not undergo carotid endarterectomy (CE) by focusing on the arterial imaging methods that will provide the essential preoperative information to help ensure appropriate selection of candidates.1
PATIENTS PROVEN TO BENEFIT FROM CE
The proven indications for
Barnett HJM, Eliasziw M, Meldrum HE. The Identification by Imaging Methods of Patients Who Might Benefit From Carotid Endarterectomy. Arch Neurol. 1995;52(8):827–831. doi:10.1001/archneur.1995.00540320111019
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