Re: Carotid Revascularization Using Endarterectomy or Stenting Systems (CaRESS): 4-year outcomes.

摘要

I read with interest the report on the 4-year outcome of the CaRESS trial (Carotid Revas-cularization Using Endarterectomy or Stent-ing Systems) and the commentary by Dr. Martin Back in the August 2009 issue of JEVT. The terms "broad risk" and "non-high-risk" are applied to the study population in both submissions, but only Dr. Back refers to the study as among a "short list of prospective trials." This is inaccurate and will be confused with the concept of randomized clinical trials, which are acknowledged universally as Level 1 evidence when properly conducted. This study cannot be classed as Level 1 evidence. I wish to make the following points.