BMJ 1995;310:1135-1136 (29 April)

Letters

Evidence is available for selected patients in selected units

EDITOR,--The art of debate is to develop a persuasive argument however inadequate the data. Mark Lambert is to be congratulated on his adroit confusion of different problems (a time honoured politician's ploy).1 The problems of poor selection, poor investigation, and poor surgery are not to be confused with an ineffective operation.

Carotid endarterectomy is not appropriate for all patients with transient ischaemic attacks any more than appendicectomy is appropriate for all patients with pain in the right iliac fossa. We know that carotid endarterectomy reduces stroke after a transient ischaemic attack by a factor of six to eight in appropriate patients operated on in appropriate units: this is proved beyond reasonable doubt. The role of the operation is proved, however, only for patients with symptoms suggesting that the carotid territory is affected and with a stenosis of >70% who are operated on by surgeons whose patients have a risk of . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Controversies in Management: Should carotid endarterectomy be purchased? Treatment avoids much morbidity
Roger N Baird
BMJ 1995 310: 316-317. [Extract] [Full Text]

Access jobs at BMJ Careers
Whats new online at Student BMJ