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Invited Commentary
June 2017

Assessing the Appropriateness of Carotid Revascularization: In the Eye of the Beholder

Author Affiliations
  • 1Dartmouth-Hitchcock Medical Center, Department of Surgery, Lebanon, New Hampshire
JAMA Surg. 2017;152(6):573. doi:10.1001/jamasurg.2017.0090

For years, debate has ensued as to what constitutes a patient who is “appropriate” for carotid revascularization. Generally, the decision to surgically intervene on carotid disease is dependent on the degree of stenosis,1 how rapidly the stenosis progressed over time, and the presence of symptoms2; however, some have posited that a surgeon’s enthusiasm may also drive use. Assessing the appropriateness of carotid revascularization procedures, like quantifying beauty, can be difficult, and ultimately this task is left to the beholder or the consulting surgeon.

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