Author(s) |
(a) The Asymptomatic Carotid Atherosclerosis Study group
(b) Executive Committee for the Asymptomatic Carotid Atherosclerosis Study
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Title(s) |
(a) Study design for randomized prospective trial of carotid endarterectomy for asymptomatic atherosclerosis
(b) Endarterectomy for asymptomatic carotid artery stenosis
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Reference(s) |
(a) Stroke 1989;20:844-9
(b) JAMA 1995;273:1421-8
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Disease |
Asymptomatic carotid stenosis (haemodynamically significant)
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Purpose |
To determine whether the addition of carotid endarterectomy to aggressive medical management can reduce the incidence of cerebral infarction in patients with asymptomatic carotid artery stenosis
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Study design |
Randomised, open, parallel-group
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Follow-up |
5 years
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Patients |
1662 patients, aged 40-79 years, with unilateral or bilateral surgically accessible stenosis in the region of the bifurcation of the common or internal carotid artery of at least 60%
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Treatment regimen |
Carotid endarterectomy or no surgery
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Concomitant therapy |
Aspirin, 325 mg/day, plus risk factor reduction counselling
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Results |
After a median follow-up of 2.7 years, the aggregate risk over 5 years for ipsilateral stroke and any perioperative stroke or death was estimated to be 5.1% for surgical patients and 11.0% for patients treated medically. This means an aggregate risk reduction of 53%
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Comments |
As a consequence of the trial reaching statistical significance in favour of endarterectomy, the study was halted and the investigators were advised to reevaluate patients who did not receive surgery
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