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William H. Edwards, MD
St Thomas Hospital Nashville, Tenn

JAMA. 1986;256(18):2515.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I agree with Brott et al¹ that carotid endarterectomy is becoming an increasingly common procedure but disagree with their recommendations on the basis of the Cincinnati area study. From our experience during the decade 1976 through 1985, "we continue to recommend internal carotid artery reconstructive surgery in symptomatic patients with a lesion and in those patients with significant stenosis, especially if other major surgery is indicated."²

Two thousand eight hundred fortyeight operations were performed on 2041 patients, with hemispheric symptoms present in 60%.³ Only fifteen percent fell into the category of significant lesions without symptoms. Operations were performed by two vascular surgeons in a university-affiliated hospital with a residency program and a vascular fellowship. The mortality rate was 1.8%. The postoperative stroke rate was 1.2%. The postoperative stroke rate due to early postoperative thrombosis has been lowered to 0.3% by the use of preoperative . . . [Full Text PDF of this Article]

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