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Noninvasive testing prior to noncardiac vascular surgery often leads to catheterization and revascularization, even though the CARP trial showed that prophylactic revascularization is no better than optimal medical therapy in low-to-moderate-risk patients (Journal Watch Cardiology Feb 4 2005). But does prophylactic revascularization provide benefit for high-risk patients?
To find out, researchers conducted a multicenter pilot study in which they randomized 101 patients with extensive ischemia (≥5 ischemic segments in a 17-segment model or ≥3 ischemic walls in a 6-wall model) to revascularization or optimal medical therapy before elective abdominal aortic or infrainguinal arterial reconstruction. Revascularization procedures included percutan…