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Brain, Vol. 124, No. 3, 455-456, March 2001
© 2001 Oxford University Press

Editorial

Risk stratification and carotid surgery: new technology but old trials

John Bamford

St James's University Hospital, Leeds, UK

It is now nearly a decade since evidence from the European Carotid Surgery Trial (ECST) and North American Symptomatic Carotid Endarterectomy Trial (NASCET) began to replace anecdote as the basis on which patients with high-grade symptomatic carotid stenosis could be advised about the risks and benefits of carotid endarterectomy (CEA). One remembers a certain sense of euphoria immediately after the interim results of these `positive' trials were published and it is striking how the calls to identify subgroups of patients for whom surgery might be particularly beneficial were much less strident than after the earlier `negative' Extracranial-Intracranial (EC-IC) Bypass Study . . . [Full Text of this Article]

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