Oh, what to do about narrowed carotid arteries?

This summary comment from the site Centre for Evidence Based Medicine Journal Watch questions the wisdom of surgically opening a narrowed carotid artery whether by inserting a stent or by surgical removal of plaque. Unfortunately, the original Lancet article is locked behind a paywall but you can access the abstract at the Lancet link.

from Journal Watch http://www.cebm.net/index.aspx?o=5422

985 If you had a TIA and a narrowed carotid artery, would you agree to have a carotid stent?I suspect that for any health professional who had read this study and the accompanying editorial by Peter Rothwell, the answer would be no. In fact the editorial points out that the main studies of endarterectomy predate modern medical management, so we don’t even have a clear idea of the extent to which surgery improves outcomes. On the evidence of this trial (ICSS) it’s safer than stenting, at least in the short and medium term; but doubts are now being raised about how often we should be tinkering with the carotid artery at all.


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