Abstract
You disagree with a referring internist about whether a mutual friend should have a carotid angioplasty or a standard carotid endarterectomy. The patient has a 99% stenosis from a complex plaque of the left internal carotid artery with recent-onset TIAs. The internist is the attending physician and is well known for a progressive attitude toward innovative treatment. The patient has asked that the internist seek your consultation. The carotid angioplasty procedure has been very recently introduced at your institution. Your recommendation for surgery has been dismissed by the attending, who is the senior partner in the medical group that provides your largest referral base. You should do which of the following?
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