What Are We Looking For? The Needle in the Haystack or the Usual Suspect?

Only patients with a high risk of stroke on optimal medical therapy (OMT) will benefit from carotid revascularisation. However, for a large range of patients there is neither clear benefit nor harm from carotid endarterectomy (CEA). Over the past decade, atherosclerotic plaques harvested during CEA have shown a time dependent change in plaque composition characterised by a decrease in features currently believed to be the cause of plaque instability,1 whereas medical therapy has improved with more widespread use of statins, more active lowering of blood pressure, and more effective antiplatelet regimens.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Invited Commentary Source Type: research