Carotid Stenosis Truths Upended by New NEJM Study
Evandro Martins, Interventional Cardiologist at the Holy House of Mercy, shared a post by Michael Gibson on X:
”Medicine keeps reminding us how temporary our “truths” are.
Today’s NEJM data: in high-grade carotid stenosis without recent symptoms, stenting lowered 4-year stroke/death vs intensive medical therapy, while endarterectomy didn’t show a significant benefit.
Guidelines, dogmas, and routines… all provisional.
We’re always just catching up with the evidence.”
Quoting Michael Gibson’s post:
”Among patients with high-grade stenosis without recent symptoms, the addition of stenting led to a lower risk of a composite of perioperative stroke or death or ipsilateral stroke within 4 years than intensive medical management alone. Carotid endarterectomy did not lead to a significant benefit.”
Read the full article here.
Title: Medical Management and Revascularization for Asymptomatic Carotid Stenosis
Authors: Thomas G. Brott, George Howard, Brajesh K. Lal, Jenifer H. Voeks, Tanya N. Turan, Gary S. Roubin, Ronald M. Lazar, Robert D. Brown, John Huston III, Lloyd J. Edwards, Michael Jones, Wayne M. Clark, Ángel Chamorro, Laura Llull, Carlos Mena-Hurtado, Donald Heck, Randolph S. Marshall, Virginia J. Howard, Wesley S. Moore, Kevin M. Barrett, Bart M. Demaerschalk, Navdeep Sangha, Herbert Aronow, Malcolm Foster, Charles Sternbergh III, Fayaz Shawl, Giuseppe Lanzino, Joseph Rapp, Hoang S. Tran, Robert Ecker, Ariane Mackey, Vaqar Ali, Curtis Given II, Philip Teal, Vikram S. Kashyap, Dipankar Mukherjee, Mark Harrigan, Scott Silverman, Matthew Koopmann, Virginia G. Wadley, Yu Zhang, J. David Rhodes, Seemant Chaturvedi, James F. Meschia
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