Outcomes of Carotid Endarterectomy

Letters15 April 1991Outcomes of Carotid EndarterectomyCamilo R. Gomez, MDCamilo R. Gomez, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-8-703_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editors: The article by Brook and colleagues (1) contains serious methodologic flaws that make some of the findings questionable and others reprehensible.First, the outcome of the study is based on "appropriateness" of carotid endarterectomy. Nobody knows exactly for what patient, if any, this procedure is appropriate. The authors themselves recognize this in their introduction and yet analyze the data based on opinions expressed by consultants (2).Second, the issue of "illness-severity" is problematic. It is unclear to what illness the authors are referring: isolated carotid artery disease? cerebrovascular atherosclerosis? ischemic brain disease? and, if so, hemodynamic? embolic?...References1. BrookParkChassinKosecoffKeeseySolomon RRMJJD. Carotid endarterectomy for elderly patients: predicting complications. Ann Intern Med. 1990;113:747-53. LinkGoogle Scholar2. WinslowSolomonChassin CDM. The appropriateness of carotid endarterectomy. N Engl J Med. 1988;318:721-7. CrossrefMedlineGoogle Scholar1. BrookParkChassinKosecoffKeeseySolomon RRMJJD. Carotid endarterectomy for elderly patients: predicting complications. Ann Intern Med. 1990;113:747-53. LinkGoogle Scholar2. BrookParkChassinKosecoffKeeseySolomon RRMJJD. Do patient, physician, and hospital characteristics affect appropriateness and outcome of selected procedures? R-3929-AARP/CF/HF/ HCFA/PMT/RWJ/RC. Santa Monica, California: The Rand Corporation; [In press]. Google Scholar3. BrookWilliams RK. Foreign medical graduates and their impact on the quality of medical care in the United States. Milbank Memorial Fund Quarterly. 1975;53:549-81. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Louis University Medical Center St. Louis, MO 63110 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 April 1991Volume 114, Issue 8Page: 703-704KeywordsAtherosclerosisBrain diseasesCarotid arteriesCarotid endarterectomyHemodynamics Issue Published: 15 April 1991 PDF downloadLoading ...