RT Journal
A1 Spence J
T1 Asymptomatic carotid stenosis: Criterion standard should be medical therapy
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD April 1
VO 144
IS 4
SP 382
OP 383
DO 10.1001/archsurg.2009.16
UL http://dx.doi.org/10.1001/archsurg.2009.16
AB 
We reported in 20054 that transcranial Doppler embolus detection was extremely effective at identifying which patients with asymptomatic carotid stenosis may benefit from revascularization. Only 10% of our patients had microemboli, and their 1-year risk of stroke was 15.6%, so they would probably benefit from revascularization. However, the 90% of patients with asymptomatic carotid stenosis without microemboli had only a 1% risk of stroke, with a very tight 95% confidence interval: 1.01% to 1.36%. They cannot benefit unless the procedure can be done with a risk of less than 1%.