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Carotid endarterectomy (CEA) is the most frequently performed operation to prevent stroke. Although previous trials have demonstrated that select patients with symptomatic or asymptomatic carotid stenosis benefit from CEA, these trials were performed 25 to 30 years ago. Medical therapy has improved considerably in recent decades, especially with the use of high-potency statins and short-term dual antiplatelet therapy, calling into question whether the results of earlier CEA trials are still applicable. These authors conducted a review of a national vascular registry in England, assessing the number of CEA cases in 2011 through 2017 with particular attention to the proportions in symptomatic and asymptomatic patients.
During the time period, …