Naylor A Ross, Bell Peter R F
Department of Vascular Surgery, Leicester Royal Infirmary, Leicester, UK.
Semin Vasc Surg. 2008 Jun;21(2):100-7. doi: 10.1053/j.semvascsurg.2008.02.001.
The landmark trials of the 1980s established a powerful precedent for demanding that "evidence" rather than "intuitive reasoning" should determine practice regarding management of patients with carotid disease. Accordingly, for our opponents to succeed in this debate, they must first demonstrate that there is little remaining confusion regarding the optimal management of asymptomatic carotid disease and then provide compelling evidence that it is now reasonable to offer carotid angioplasty with stenting without the protection of randomized trials. It is our contention that neither can be demonstrated and that the motion cannot be sustained.
20世纪80年代具有里程碑意义的试验确立了一个强有力的先例，即要求用“证据”而非“直观推理”来决定颈动脉疾病患者的治疗方案。因此，我们的反对者若想在这场辩论中获胜，他们首先必须证明对于无症状颈动脉疾病的最佳治疗方案已几乎不存在争议，然后提供令人信服的证据，表明现在在没有随机试验验证的情况下提供颈动脉血管成形术加支架置入术是合理的。我们认为这两点都无法得到证实，因此该动议无法成立。
