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Carotid endarterectomy (CEA) is a procedure that reduces stroke risk in selected patients with symptomatic or asymptomatic carotid stenosis. However, periprocedural complications can include stroke or death. Whether ultrasound used therapeutically would reduce the complication rate is unknown. These researchers conducted a randomized trial of patients undergoing CEA, assigning them to either ultrasound treatment via transcranial Doppler insonation of the middle cerebral artery or a sham control group. A sonographer provided ultrasound for up to 120 minutes. The primary outcome was ischemic stroke, transient ischemic attack, or death within 30 days. In a substudy, patients had a baseline MRI and follow-up MRI after 24 hours to detect new bra…