Frank A. Lederle, MD
To the Editor: In the recent position paper developed for the American College of Physicians on carotid endarterectomy, Cebul and Whisnant (1) advocate surgery for patients with transient ischemic attacks and ipsilateral carotid stenosis. They support this position with results of the Joint Study of Extracranial Arterial Occlusion (2) after exclusion of the data on surgical complications. This exclusion invalidates the randomized design of the study, however. When the results of the Joint Study are properly viewed with the data on surgical complications included, 45 strokes and deaths occurred in 169 surgical patients (27%) and 38 in 147 medically treated
Lederle FA. Carotid Endarterectomy. Ann Intern Med. ;112:383–384. doi: 10.7326/0003-4819-112-5-383
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Published: Ann Intern Med. 1990;112(5):383-384.
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