| Carotid Endarterectomy Efficacy | |
|---|---|
| (NASCET) Beneficial Effect of Carotid Endarterectomy In Symptomatic Patients with High-Grade Carotid Stenosis _____ Multicenter RCT demonstrating significant benefit of carotid endarterectomy + medical management vs medical management alone in symptomatic high grade carotid stenosis | LINK |
| (ECST) Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial _____ Multicenter RCT comparing surgical to non-surgical intervention of symptomatic carotid stenosis, demonstrating a net benefit of surgery in stroke reduction in patients with carotid stenosis greater than ~80% (equivalent to ~70% by NASCET criteria) | LINK |
| Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis _____ Pooled data from NASCET, ECST, and VA309 analyzed for surgical efficacy, finding modest benefit of CEA for stroke/death reduction in those with 50-69% stenosis, and high benefit in those with >70%. No significant benefit is seen in near-occlusion. | LINK |
| Sex Difference in the Effect of Time From Symptoms to Surgery on Benefit From Carotid Endarterectomy for Transient Ischemic Attack and Nondisabling Stroke _____ Pooled data from NASCET and ECST analyzed for risk of stroke, operative stroke/death, and surgical benefit by sex and time to surgery after event, finding that surgical risk is not increased in the <2 week period, that surgical benefit decreases with time since event, that men with 50-69% stenosis have surgical benefit only in the <2 week period, and that surgical benefit for women is significant only for >70% stenosis in the <2 week period. | LINK |
| Carotid Endarterectomy vs Carotid Stenting | |
|---|---|
| (CREST) Stenting vs Endarterectomy for Treatment of Carotid-Artery Stenosis _____ RCT comparing CEA to CAS for asymptomatic or symptomatic carotid stenosis, finding no difference in the composite of stroke/MI/death between groups at 4 years; stenting had a higher rate of periprocedural stroke, and CEA of periprocedural MI. | LINK |
| (SAPPHIRE) Long-Term Results of Carotid Stenting versus Endarterectomy in High-Risk Patients _____ RCT data of CEA vs CAS at 3 years in patients high-risk for CEA complications, finding no significant difference in long term outcomes between CEA and stenting groups. Prior published 1-year data found CAS to be not inferior CEA. | LINK |
| Carotid Artery Stenting Versus Endarterectomy for Treatment of Carotid Artery Stenosis _____ Review of RCTs comparing CEA with CAS for symptomatic or asymptomatic carotid stenosis, finding that in symptomatic stenosis, CAS is associated with higher periprocedural stroke or death primarily in patients age >70, and lower risk of MI than CEA. There is no difference in efficacy beyond 30 days. | LINK |