We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Endarterectomy for Asymptomatic Carotid Artery Stenosis

Eugene Oddone, MD; Kevin Waters, MD
JAMA. 1995;274(19):1506. doi:10.1001/jama.1995.03530190019016.
Text Size: A A A
Published online


To the Editor.  —Because the number of patients screened (42 000) greatly exceeded the number of patients randomized (1662), the generalizability of the ACAS1 results needs to be examined more closely. Although the ACAS authors were careful in their report, they failed to highlight the danger of applying their results to the general population. The public policy implication of the ACAS results will most likely affect truly asymptomatic patients (only 46% of ACAS study patients). Furthermore, primary care clinicians will wonder whether or not to screen these patients. What ACAS authors failed to emphasize is that screening truly asymptomatic patients with noninvasive tests, performing carotid angiography on all patients with positive tests, and finally performing carotid endarterectomy on patients with greater than 60% stenosis of any internal carotid artery will never prevent strokes in the long run.The problem arises because the prevalence of carotid artery stenosis (>60%) in


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.