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Ann Thorac Surg 2001;71:781-782
© 2001 The Society of Thoracic Surgeons

Invited commentary

Norman R. Hertzer, MDa

a Department of Vascular Surgery, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA

I am concerned with at least two aspects of this report because they seem to violate a couple of principles that I consider to be important in the management of patients with asymptomatic carotid stenosis. The first of these principles is based on the fact that the short-term efficacy of carotid endarterectomy (CEA) to prevent perioperative strokes in conjunction with other surgical procedures is largely intuitive. The only proven benefit of CEA is a relative reduction in the long-term stroke risk associated with truly severe (80% to 99%) carotid stenosis using the . . . [Full Text of this Article]






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