Myrtle Gruenwald is an 80-year-old relatively healthy woman with a 5-year history of cerebral ocular events,ultrasound-revealed irregular plaque formation in both carotid arteries,and several recent ischemic events.A risk reduction clinical decision strategy for Myrtle,based on best evidence and best practices,would be:

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Major advances have been made during the past several decades in stroke prevention,treatment,and rehabilitation.Patients with cerebral ocular events,an irregular plaque surface,recent ischemic events,and carotid stenosis are likely candidates for surgery.A best practice (often referred to as evidence-based practice [EBP])is using "best evidence" to make clinical decisions and eliminate inappropriate or ineffective care.Patients with asymptomatic carotid stenosis have a low risk of stroke.However,carotid disease includes stenosis as well as stable and unstable plaque formation.

Myrtle Gruenwald Is an 80-Year-Old Relatively Healthy Woman with a 5-Year