This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Optimal antiplatelet therapy in moderate to severe asymptomatic carotid stenosis: a comprehensive review of the literature. Eur J Vasc Endovasc Surg 2019; 57: 199-211.

Published: 2nd August 2019

Authors: Murphy SJ, Naylor AR, Ricco J-B, Sillesen H, Kakkos S, Halliday H et al.

Conclusion

A total of 25 RCTs were included. Even though a single RCT showed no benefit, the authors argue low dose aspirin is worthwhile in asymptomatic stenosis. The same is recommended, with better evidence in patients undergoing endarterectomy or endovascular therapy. There is insufficient evidence to recommend dual antiplatelet therapy in patients with symptomatic moderate to severe carotid stenosis.

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