Current medical intervention alone is now the best solution for asymptomatic carotid stenosis. letter to the editors of Journal of Vascular Surgery and the European Journal of Vascular and Endovascular Surgery regarding trans-atlantic debate no. 1.

摘要

Current medical intervention alone is now best for prevention of stroke associated with asymptomatic carotid stenosis.1 Dr Schneider's case against this conclusion is fatally flawed because it is based on an outdated, over-reliance on borderline significant results from historical randomised carotid endarterectomy (CEA) trials ('level 1 evidence') and underestimation of the counter-evidence.1'2 There have been significant falls in average annual rates of ipsilateral and any territory stroke (+/- TIA) with medical intervention alone since the early 1980s, rates falling below those of patients who received medical intervention and CEA in randomised trials.