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Would you perform carotid artery stenting with embolic protection in an 80 year old man with an asymptomatic, 80-99%, unilateral internal carotid artery stenosis?
Always, if the anatomy can be negotiated.
Only in a clinical registry or trial.
Only if transcranial Doppler (TCD) detects cerebral emboli, denoting high risk for adverse neurological events.
Never.
Refer for carotid endarterectomy if not surgically high-risk.
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