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To the Editor:
I read with interest the article by Kennedy et al.,1 which stressed the importance of imaging modality in decision making about carotid endarterectomy. As the authors state, the source of information for the degree of internal carotid artery stenosis is crucial in making appropriate decisions. In their final paragraph, they choose to “make physicians aware” of the limitations of noninvasive imaging strategy. While we agree with their good advice and overall conclusions, they failed to point out some of the problems with interpretation of the imaging literature.
Conventionally performed catheter angiography is no longer a gold standard, as a comparative study with rotational angiography has previously shown.2 The reasons why conventionally performed catheter angiography is not and …
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