To the Editor.— The impressive results of extracranial vascular surgery in the treatment of transient cerebral ischemic attacks reported by Fields et al (211: 1993, 1970) are considerably better than witnessed by myself. After carefully reviewing their reported data, several criticisms may be noted. These conclusions appear better than the actual data would support, since mortality and morbidity of surgery were excluded from the final tabulation of results of treatement. If one considers their total data from the standpoint of poor results (subsequent nonfatal or fatal stroke) and death from other causes, it can be seen from the table that there is little difference between the surgical and nonsurgical groups in each category of vascular disease. It becomes apparent that these results are only impressive in regard to the number of patients who continue to have transient neurological symptoms without stroke. There is no clear understanding of the criteria for