Evidence map›Paper›PMID 26711272›Full record

ReviewCurrent neurology and neuroscience reports2016

Management of Patients with an Asymptomatic Carotid Stenosis--Medical Management, Endovascular Treatment, or Carotid Endarterectomy?

J David Spence

Abstract readReview
PubMed Publisher
In one paragraph

Review in Current neurology and neuroscience reports, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Management of asymptomatic carotid stenosis.Annals of translational medicine · 2020
    Review
  2. Large Artery Atherosclerotic Occlusive Disease.Continuum (Minneapolis, Minn.) · 2017
    Review
  3. Article
  4. Review
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

J David SpenceStroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, 1400 Western Road, London, ON, Canada, N6G 2V4. dspence@robarts.ca.

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

Patients with asymptomatic carotid stenosis all warrant intensive medical therapy; they are at a higher risk of myocardial infarction than of stroke. With modern intensive medical therapy, the annual risk of ipsilateral is now ∼ 0.5%. Justifying carotid intervention on the basis of the results of historic trials with a medical arm, extrapolated to modern trials with lower interventional risks but no medical arm is not legitimate. Most patients (∼ 90%) with asymptomatic carotid stenosis would be better served by intensive medical therapy than by either stenting or endarterectomy. The few (∼ 10%) who could benefit from intervention can be identified by microemboli on transcranial Doppler and other methods in development. Routine stenting of asymptomatic carotid stenosis, because it is more likely to harm than help the patient, may be considered unethical.

Indexed as

Endarterectomy, CarotidCarotid StenosisEndovascular ProceduresHumansMyocardial InfarctionStentsStrokeAsymptomaticCarotid stenosisEndarterectomyIntensive medical therapyManagementStenting

Identifiers

PMID26711272

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.