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The authors argue that carotid angioplasty and stenting should be restricted to recurrent and radiation-induced disease until randomized trials prove its efficacy over carotid endarterectomy in "high-risk" patients.
The concept of a "high-risk" carotid endarterectomy patient has been suggested in an effort to justify the application of carotid angioplasty and stenting outside of clinical trials. Contemporary results of carotid endarterectomy in this subgroup of patients would argue against the existence of a high-risk patient. Until randomized prospective trials establish the role of carotid angioplasty and stenting in carotid bifurcation disease, this new technology should be restricted to recurrent and radiation-induced disease.
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Gasparis et al. (2003) studied this question.
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