Endarterectomy for asymptomatic carotid artery stenosis

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7028.442c (Published 17 February 1996) Cite this as: BMJ 1996;312:442
  1. Carlos S Kase,
  2. Philip A Wolf
  1. Professor of neurology Professor of neurology and epidemiology Boston University School of Medicine, Department of Neurology, Boston, MA, USA

    EDITOR,—We agree with Craig D Irvine and colleagues' general caution about the appropriateness of prophylactic carotid endarterectomy in asymptomatic patients.1 The editorial, however, contains some imprecise statements that may lead readers to question the validity of this cautious approach.

    Firstly, Irvine and colleagues state that 20-30% of strokes may be related to carotid disease, citing a paper by Timsit et al.2 This estimate, however, is imprecise, as Timsit et al's data indicate that 8.8% (113 of 1273) of ischaemic strokes are “atherothrombotic” and about …

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