Reply to the Letter by A Abbott Regarding “Asympt

Authors: Margaret H Walkup Peter L Faries

Publish Date: 2011/04/20

Volume: 13, Issue: 4, Pages: 268-268

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Abstract

Dr Abbott has raised several very interesting issues It is important to note that rather than errors the subjects Dr Abbott highlights are the interpretations of data as reported in the original studies Our interpretation agrees with that of the authors of the original manuscripts Recommendation guidelines from both the American Heart Association as well as the Society for Vascular Surgery support intervention to correct asymptomatic carotid stenosis 80 for patients in whom a 3 perioperative aggregate stroke/death rate can be achieved This is based on level I evidence accrued in numerous randomized controlled trials No level I or level II evidence exists to support observation and medical management of these patients We would welcome a randomized prospective trial to assess whether any improvement in the natural history of asymptomatic carotid stenosis can be achieved with current medical therapy And it is our sincere hope that medical therapy can progress the point at which intervention for carotid stenosis is no longer required especially as we begin to ageWe apologize for the typo in the introduction of our paper when we stated that the ACAS trial “…randomized over 4500 patients with asymptomatic carotid stenosis…” This should have read that the ACAS trial had over 4500 patientyears of observation for patients with asymptomatic carotid stenosis

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