Asymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.

<h4>Objectives</h4> <p>To compare carotid endarterectomy with carotid artery stenting in the prevention of stroke in patients with asymptomatic carotid stenosis.</p> <h4>Design</h4> <p>A large, simple, pragmatic international trial of at least 5000 patients...

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Main Authors: Rudarakanchana, N, Dialynas, M, Halliday, A
Format: Journal article
Language:English
Published: Elsevier 2009
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author Rudarakanchana, N
Dialynas, M
Halliday, A
author_facet Rudarakanchana, N
Dialynas, M
Halliday, A
author_sort Rudarakanchana, N
collection OXFORD
description <h4>Objectives</h4> <p>To compare carotid endarterectomy with carotid artery stenting in the prevention of stroke in patients with asymptomatic carotid stenosis.</p> <h4>Design</h4> <p>A large, simple, pragmatic international trial of at least 5000 patients with asymptomatic carotid stenosis in whom intervention is thought to be needed but where there is substantial uncertainty about the appropriate choice of treatment. The trial is designed to fit in easily with normal clinical practice.</p> <h4>Materials and Methods</h4> <p>A short (~2 min) telephone call is made to randomise patients to either carotid endarterectomy (CEA) or stenting (CAS). Follow-up by the collaborator will be at one month after the procedure (simple 1-page form) and by the ACST office for 5-years post-procedure. Data will be analysed on an intention-to-treat basis; main outcomes will be 30-day myocardial infarction, stroke and death, and 5-year stroke rates. In addition, appropriate subgroup analyses will be undertaken, and health economic evaluation will consider procedural and stroke-related healthcare costs and quality of life.</p> <h4>Conclusion</h4> <p>Collaborators who routinely undertake CEA and CAS are encouraged to participate in ACST-2. This trial, now funded and open for randomisation, will provide important evidence comparing the immediate and long-term safety and efficacy of carotid endarterectomy and stenting in patients with asymptomatic carotid stenosis.</p>
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spelling oxford-uuid:349d4577-8fdf-42e9-b612-13dc2b488f952022-03-26T13:27:05ZAsymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:349d4577-8fdf-42e9-b612-13dc2b488f95EnglishSymplectic Elements at OxfordElsevier2009Rudarakanchana, NDialynas, MHalliday, A<h4>Objectives</h4> <p>To compare carotid endarterectomy with carotid artery stenting in the prevention of stroke in patients with asymptomatic carotid stenosis.</p> <h4>Design</h4> <p>A large, simple, pragmatic international trial of at least 5000 patients with asymptomatic carotid stenosis in whom intervention is thought to be needed but where there is substantial uncertainty about the appropriate choice of treatment. The trial is designed to fit in easily with normal clinical practice.</p> <h4>Materials and Methods</h4> <p>A short (~2 min) telephone call is made to randomise patients to either carotid endarterectomy (CEA) or stenting (CAS). Follow-up by the collaborator will be at one month after the procedure (simple 1-page form) and by the ACST office for 5-years post-procedure. Data will be analysed on an intention-to-treat basis; main outcomes will be 30-day myocardial infarction, stroke and death, and 5-year stroke rates. In addition, appropriate subgroup analyses will be undertaken, and health economic evaluation will consider procedural and stroke-related healthcare costs and quality of life.</p> <h4>Conclusion</h4> <p>Collaborators who routinely undertake CEA and CAS are encouraged to participate in ACST-2. This trial, now funded and open for randomisation, will provide important evidence comparing the immediate and long-term safety and efficacy of carotid endarterectomy and stenting in patients with asymptomatic carotid stenosis.</p>
spellingShingle Rudarakanchana, N
Dialynas, M
Halliday, A
Asymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.
title Asymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.
title_full Asymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.
title_fullStr Asymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.
title_full_unstemmed Asymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.
title_short Asymptomatic Carotid Surgery Trial-2 (ACST-2): Rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis.
title_sort asymptomatic carotid surgery trial 2 acst 2 rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis
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AT dialynasm asymptomaticcarotidsurgerytrial2acst2rationaleforarandomisedclinicaltrialcomparingcarotidendarterectomywithcarotidarterystentinginpatientswithasymptomaticcarotidarterystenosis
AT hallidaya asymptomaticcarotidsurgerytrial2acst2rationaleforarandomisedclinicaltrialcomparingcarotidendarterectomywithcarotidarterystentinginpatientswithasymptomaticcarotidarterystenosis