High Risk Plaque, High Risk Patient or High Risk Procedure?

Citations of this article
Mendeley users who have this article in their library.


SAPPHIRE, a randomised trial of endarterectomy versus angioplasty in 'high-risk' patients, concluded that angioplasty was 'not inferior' to surgery. This has subsequently been translated to mean that angioplasty was 'preferable' or 'advisable' in patients considered high-risk for surgery, with no further discrimination between symptomatic and asymptomatic individuals. Moreover, there have been suggestions that the accepted procedural risks may have to be increased in these patients. In fact, 71% of patients in SAPPHIRE were asymptomatic in whom there was an average 6% 30-day death/stroke rate. At this level of risk, neither surgery nor angioplasty could ever prevent long-term stroke. The concept of identifying high-risk patients is laudable, but they should be high risk for stroke (i.e. symptomatic). There is currently little systematic evidence to include asymptomatic patients within this definition. © 2006 Elsevier Ltd. All rights reserved.




Naylor, A. R., & Golledge, J. (2006). High Risk Plaque, High Risk Patient or High Risk Procedure? European Journal of Vascular and Endovascular Surgery, 32(5), 557–560. https://doi.org/10.1016/j.ejvs.2006.05.017

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free